Great! Providers, parents and just about anyone who has a special interest in children can join our association.
Not sure if you can make it to a meeting? No problem! You can print off the application below, complete and mail to: Tammy Shroyer, CPFCCPA Membership Coordinator, 4914 Thornbriar Court, Land O'Lakes, FL 34639.
Please feel free to call Tammy at 813/995-0085 with any questions you may have regarding membership.
CENTRAL PASCO FAMILY CHILD CARE PROVIDERS ASSOCIATION
MEMBERSHIP APPLICATION
Licensed ____ Registered ____
Name:
Phone:
Address:
City: Zip:
Major Crossroad:
School District:
Email:
Are you currently a member of another family childcare providers association? Yes No
If so, name of association:
CAREER ACCOMPLISHMENTS:
_____ NATIONAL ACCREDATION _____ MASTER PROVIDER
_____ CDA _____ 2nd HELPING GRADUATE
_____ ECA _____ DEGREE / MAJOR
PLEASE CHECK ALL THAT APPLY TO YOUR CHILD CARE BUSINESS:
_____ INFANTS (Birth to 12 mos.) _____ EVENING _____ SATURDAY
_____ CURRICULUM _____ TODDLERS (13 mos.-3) _____ FIELD TRIPS
_____ PRESCHOOLERS (4 & 5) _____ SUNDAY _____ MEALS
_____ BEFORE/AFTER SCHOOL _____ OVERNIGHT _____ TRANSPORT
_____ FOOD PROGRAM _____ SPECIAL NEEDS _____ PART TIME
_____ VOUCHER PROGRAM _____ DROP IN
_____ OTHER ______________
Provider's Signature: ________________________________
Date Joined: ______________________________
Dues paid by Check # Cash $
Received by:
