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Rainwater Pre-Qualifier Application
Rainwater Pre-Qualifier Application
Name of Center
*
Year Established
*
County
*
Complete Address
*
Mailing Address (if different)
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Phone
Fax
Website
Center Owner
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Email
*
Center Director
*
Email
*
Assistant Director
Email
Executive Director
Email
Who is the primary contact?
*
Is the center licensed by the Texas Department of Protective & Regulatory Services?
*
Yes
No
Date license was issued
*
Is the center a 501(c)(3)?
*
Yes
No
Texas Rising Star?
*
Yes
No
Is the center accredited by NAEYC or NAC?
*
Yes
No
Date center was accredited
Renewal date
Hours of operation
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am/pm
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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:
Capacity of center
*
Capacity for birth–5 yrs
*
Current enrollment birth-5 yrs
*
Number of Classrooms (Infant)
*
Number of Classrooms (Toddler)
*
Number of Classrooms (PreK)
*
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?
*
Previous Educational First Steps affiliate
*
Yes
No
If yes when?
*
Why do you want the center to be affiliated with Educational First Steps?
*
Type the characters
*
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