Membership Registration

  • Contact Person or Director

  • Program Statistics

  • Enter #'s for each program or N/A
  • Enter #'s for primary program or N/A (we will capture the rest off of the state list)
  • Enter # or N/A
  • Enter # or N/A
  • Enrollment Statistics

  • Enter number here
    Please enter a number from 0 to 99999.
  • Enter number here
    Please enter a number from 0 to 9999.
  • Locations

  • Select number (up to 2 locations)
  • Select number for additional (locations 3+)
  • Select Number (up to 2 locations)
  • Select Number for additional (locations 3+)
  • Select number for up to 2 locations
  • Select number for additional (locations 3+)
  • Membership Dues

    Membership dues are based on program type/size and how many site locations. All programs for the governing body should be included in membership. The price break down is: $50 Family Child Care Home $6o School aged Program (first 2 locations each) $50 School aged Programs (location 3+ each) $200 Small Center (first 2 locations each) $120 Small Center (location 3+ each) $250 Large Center (first 2 locations each) $140 Large Center (location 3+ each) All new registrations are subject to administrator approval. Currently 15% of your dues and contributions may be tax deductible as a business expense. 85% of membership dues in 2021 support our lobbying and are not tax deductible. Upon completion of this form you will receive an invoice within 24 business hours.