Become A Partner Center

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Center Owner First Name*

Center Owner Last Name*

Center Owner Email*

Do you have a Center Director?*

Yes

Center Director First Name*

Center Director Last Name*

Center Director Email*

Do you have an Assistant Director?*

Yes

Assistant Director First Name*

Assistant Director Last Name*

Assistant Director Email*

Primary Contact*

First Name*

Last Name*

Email*

Is the center a 501(c)(3) organization [tax-exempt]?*

Yes

Business Structure*

HHSC Licensing*

Yes

HHSC License Issued Date*

Accredited?

No? Leave blank. You also can select more than 1

NAC Accredited Date*

NAEYC Accredited Date*

NAFCC Accredited Date*

Texas Rising Star Accredited Date*

Additional Attributes

None? Leave blank. You also can select more than 1

Licensing Capacity*

Capacity for birth – 5 yrs*

Current enrollment birth – 5 yrs*

Number of classrooms (Infant)*

Number of classrooms (Toddler)*

Number of classrooms (Pre-K)*

Number of teachers*

Number of After School Classrooms*

Number of Non-operational Classrooms*

How many students, birth – 5 yrs, receive CCMS funding in the Center?*

How many students, birth – 5 yrs, in your center are from families who are eligible for Free/Reduced lunch subsidies through CACFP/USDA?*

Previous Educational First Steps affiliate?*

Yes

When?*

Your Goal

Why do you want your center to be affiliated with Educational First Steps?*

This field should be left blank

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Become A Partner Center

Physical Address

Mailing Address

Websites

Hours of operation