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We offer two membership options.
Option 1
Option 2
Members
who do not wish to be listed in the daycare directory need not follow these
guidelines. Dues will be $25.00.
ODCP
Membership Form
Name: |
______________________________________________________________ |
Address: |
______________________________________________________________ |
______________________________________________________________ |
|
Phone: |
______________________________________________________________ |
Membership
Option (please circle one) |
||
1 |
2 |
Do
not wish to be listed in directory |
Are
you licensed? YES NO
License #______________ |
What
are your operating hours & weekly fee? |
What
ages of children do you accept in your day care? |
How
did you find out about the ODCP? |
YES |
NO |
I
am a license-exempt provider, I care for no more
than 3 children in addition to my own. |
YES |
NO |
I
am a licensed provider, I follow NH licensing regulations. |
YES |
NO |
My
child care area is free of hazards and a safe environment for children. |
YES |
NO |
I
serve nutritious meals and snacks to the children. |
YES |
NO |
I
have age-appropriate toys and provide a balance of active and restful
activities. |
YES |
NO |
A
member of my family has been convicted of child abuse or neglect. |
YES |
NO |
I
have an emergency evacuation plan for my home which is practiced with the
children. |
YES |
NO |
I
have working smoke detectors that I check periodically. |
YES |
NO |
I
have information on emergency contacts for each child. |
YES |
NO |
I
supply parents with my social security number or tax ID number and report my
day care income to the IRS. (This is required of all providers, licensed or
exempt, by federal law.) |
____________________________________________________ |
Signature |
______________________________________ |
Date |
Send
this completed form with the $25 or $50 nonrefundable Manchester,
NH 03102 |
How
could you help the ODCP?? |