Filling out and submitting this form is the first step toward becoming a provider operating a regulated family child care home. Details of the approval process.Application to operate a regulated family child care homeBasic applicant infoName(Required) First Last Date of Birth(Required) DD slash MM slash YYYY Mailing Address(Required) Number and street or PO Box number City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Phone(Required)Email(Required) Proposed operational detailsName of your Family Child Care Home(Required)Street location of your Family Child Care Home(Required) Street Address City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Proposed number of child care spaces(Required)Details of child care spaces you presently have filled (if any)Number of full-time spacesNumber of part-time spacesAge range of these childrenIndicate the areas of your home that will be used for child care (excluding the bathroom)(Required)Family child care hours of operation: start Hours: Minutes AMPM AM/PMHours of operation: close Hours: Minutes AMPM AM/PMMonths of operation January February March April May June July August September October November DecemberSelect AllDays per week Sunday Monday Tuesday Wednesday Thursday Friday SaturdaySelect AllPlease list the names and date of birth of your own children from birth to 13 yrs. old who will be in your family child care home during the hours of operationNameDate of birth Add RemoveList other people residing in your homePlease give a brief description of your experience in providing child care.Consent: By submitting this form, I understand that I am sharing this information with the Family and Child Care Connections team and agree to be contacted by a home visitor.(Required) I agreeAll information will be kept confidential.CommentsThis field is for validation purposes and should be left unchanged.
