Apply To Provide Child Care

    Would you like to apply to become a Provider with TotLot Licensed Childcare?


    This information will be considered ONLY if completed in full. Please answer ALL questions.


    Please list ALL children under, 13-years-old, living in your home:

    Please list ALL children, under 13-years-old, for whom you are currently responsible during the hours you will provide day care, whether paid or unpaid (i.e. day care children, grandchildren, etc.):




    You will be contacted when we are seeking child care providers in your area.


    Thank you for your interest!