ERC Child Care Intake Form
in Adobe PDF Reader format to print, then mail or fax
 

Options for submitting an ERC Child Care Intake Form

Open and print our intake form. Please fill out and send us your completed intake form using

USPS mail
or
FAX (785) 357-1813.

For more information, please Call ERC at 785-357-5171 or 1-800-279-2ERC (2372) or e-mail erc@ercrefer.org

You can also conduct your on-line search

Visit www.kaccrra.org or www.srskansas.org for more information on programs that help parents and child care providers.

 
Adobe Reader