Licensing Interest Thanks for reaching out! Please complete the information below. You can expect a response from us within two business days. First name Last name Phone Email address County where program will be located: Becker Cass Crow Wing Douglas Morrison Otter Tail Stevens Todd Wadena What type of license program are you pursuing? Family child care Adult foster care If you are interested in an adult foster care license, do you plan to pursue a 245d license as well? Yes No Have you been licensed before? Yes No Do you need interpreter services? Yes No If yes, please specify language. Do you have any Hispanic Heritage? The county licensing system we use requires this information, it's part of its audit requirement. Yes No What question(s) do you have about becoming a licensed provider? If you are planning to pursue a family child care license, we are seeking your permission to share your contact information (name, county, phone number, and e-mail address) to the Wayfinder Navigators to help you navigate the resources as a potential applicant. By selecting, yes, you are giving us permission to share your contact information to the designated Navigator Wayfinder. By selecting, no, we will not refer your contact information. Yes No If you are planning to pursue a family child care license, we are seeking your permission to make a referral with your contact information (name, county, phone number, and e-mail address) to the Workforce Advisor through Empower to Educate to help you navigate and register for the required professional development as a family child care applicant. By selecting, yes, you are giving us permission to share your contact information to the designated Workforce Advisor and they will be reaching out to you by email once you have submitted your applicant packet. By selecting no, we will not refer your contact information. Yes No
