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Name of Center
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Year Established
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Street Name
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City
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Zip Code
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County
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Mailing Address (if different)
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Phone
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Website
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Center Owner
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Email
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Center Director
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Email
*
Assistant Director
Email
(Center's) Social Media Handle
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Who is the primary contact?
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Licensing Number
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Date license was issued
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Is the center a 501(c)(3)?
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Yes
No
Texas Rising Star?
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Yes
No
TRS Star Level
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Entry Level
2
3
4
Is the center accredited by NAEYC or NAC?
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Yes
No
Date center was accredited
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Renewal date
Hours of operation
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Hour
HH
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am/pm
am/pm
am
pm
to
Hour
HH
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Minute
MM
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am/pm
am/pm
am
pm
Is the center open year round?
*
Yes
No
If no, please specify
*
Does the center offer transportation?
*
Yes
No
Complete the following information on children currently served by the center:
Licensing Capacity
*
Operating Capacity
*
Capacity for birth–5 yrs
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Current enrollment birth-5 yrs
*
Number of Classrooms (Infant)
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Number of Classrooms (Toddler)
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Number of Classrooms (PreK)
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Number of Teachers
*
How many students birth-5 receive CCMS funding in the center?
*
How many birth-5 children in your center are from families who are eligible for Free or Reduced lunch subsidies through the CACFP/USDA?
*
What center attributes do you participate in?
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After School Program
USDA/CACFP
Woman-Owned
Transportation
Faith-based
Pre-K Partnership
CCMS Provider
Previous Educational First Steps affiliate
*
Yes
No
If yes when?
*
Are you currently partnered with an ISD Pre-K partnership?
*
Yes
No
Why do you want the center to be affiliated with Educational First Steps?
*
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