Directions for filling out the Child Care Provider Request form:

• The information you submit is strictly confidential and used only for the purpose of generating child care information
  
  
• Please use the Tab Key to move from box to box (Don't use the Enter Key)
  
  
• An * indicates a Required Field. Failure to fill out all required fields can result in an unsuccessful request.
  
  
• Your information will be entered into our database and the computer system will search and match your needs and preferences with a listing of approximately 1,150 child care providers in Pinellas County
  
  
• We will then E-Mail a listing of child care providers that matches your request
  
  
• Please note that these providers are not rated or recommended by Child Care Resource and Referral
  
  
• Your packet will contain several useful items, which we encourage you to review prior to your decision
  
  
• If you should have any questions or concerns please contact CCR&R at
  727-547-5750 or toll free at 1-866-764-0436
  
  
• CHILD APPLICATION: This web application is set up to request child care for two children. If you should need additional forms for other children you will need to complete the Additional Children Form and submit it. At that time you will receive a confirmation page with a link to continue filling out additional requests for other children if needed.

Parents can also contact the CCR&R service by phone at
727-547-5750 or toll free 1-866-764-0436

Click here for the Child Care Provider Request form Online Application