Child Care Referral Form

To translate the form into Spanish or another language (Para traducir el formulario al español u otro idioma):

Open the form using Google Chrome web browser. Download Chrome here. (Abra el formulario con el navegador web Google Chrome. Descarga Chrome aquí.)
Anywhere on this form, right click and you will see a drop-down menu. (En cualquier lugar de este formulario, haga clic con el botón derecho y verá un menú desplegable.)
Select “Translate to …” (Selecciona "Traducir a ...".)
Choose the language you would like it to be translated to. (Elija el idioma al que le gustaría que se tradujera.)
Repeat steps 2-4 on each new form page. (Repita los pasos 2 a 4 en cada nueva página de formulario.)

Please add another address you would like to use for your child care search area.

Please specify your family size and how many children and adults live in your household.

Please provide information for each child in need of care. Click "Add another child" to add additional children.

Preferred Days & Times
Please add times next to the days on which you need care.
For example, write 8 am - 5 pm next to Mondays, Tuesdays, and Wednesdays.

Raising your voice to support early childhood education in Alaska can elevate child care issues and create positive change that benefits children, families, and the communities where you live. Visit thread's Action Center, where you can learn more about the issues, take action, and sign up for Action Alerts to get email or text notifications when we need your voice. Click here to visit thread's Action Center