Child Care Application

Application for Child Care

You can
- complete this form online and submit it; or
- print this form, complete it and fax it to 416-922-5335; or
- contact our Child Care Services Department at 416-922-3434 / 1-800-263-9703 during business hours and provide the information over the phone.
The information collected on this form is only used for processing your application for child care with Family Day Care Services.
Family Day will contact you within two business days after we receive the application.

Child care information

I am interested in: Home Child Care Child Care Centre Both

Family Day offers child care in the following areas. Please indicate the areas where you are looking for child care (check all that apply):

Brampton/Bramalea Richmond Hill North York (Leslie St - Victoria Park Ave.)

Mississauga Thornhill East York

Bolton Markham Scarborough

What major road intersection is closest to where you require child care:

If you are applying for centre-based child care and know the name of the Family Day centre, please tell us:

Will you be using a car or public transit to take your child(ren) to care?

Car Public Transit

On what days of the week do you need child care: (please check all days required)
Note: Child Care Centres provide care Monday - Friday only. Home Child Care may be available on Saturday
and/or Sunday.

Monday Tuesday Wednesday Thursday Friday

Saturday Sunday

I want to drop my child(ren) off at

I want to pick my child(ren) up at

I would like my child(ren) to start care on:
	month	date	year

Contact information

First Name
Surname
Street Address
Address (continued)
City	Province Postal Code

At what telephone number can you be reached Monday - Friday, 8:30 am - 4:30 pm?

Phone Number	- area code	work home cell/mobile
Alternate Number	- area code	work home cell/mobile

What is your email address?

Child(ren) requiring care

Child's name (first and last)	Gender	Child's birth date			School (if applicable)
Child's name (first and last)	Gender	month	day	year	School (if applicable)

If any of these children have allergies, food restrictions or other special needs that we need to be aware of, please tell us about them:

Other information

Will you be using government fee assistance (subsidy)?
Yes What is your Client File #, if known?

If you require fee assistance and have not yet applied, please contact the appropriate Children's Services office.
Toronto: 416-392-5437 Peel Region: 905-791-1585 York Region: 905-830-9487

Is there anything else you would like to tell us about your application for child care?

How did you hear about Family Day?

Thank you for considering Family Day Care Services in your search for high quality child care.