Machildcare.Com
Child Care Provider Advertising Form
Option 1 - See Instructions at Bottom of Page

Enter Your Information...Please do not use all CAPS!

Name
Street Address
City/State/Zip
Telephone #
Email Address
Type Program	Family Child Care Group Child Care Group & School Age Child Care School Age Only
License #
Expiration Date
Total Capacity
Infant Capacity
Toddler Capacity
Preschool Capacity
Schoolage Capacity
Description (50 words or less)

Before submitting this form, please forward payment ($25 for a family child care provider; $50 for a group center and/or school age program), along with a copy of your current license, to:

2 Dolphin Group, Inc.
P.O. Box 430
Chelmsford, Ma 01824-0430

Please make checks payable to 2 Dolphin Group, Inc.

Once your information has been added to our files, we will notify you via email. At that time, we will also send you your Userid and Password which will enable you to access the particular message boards which will only be open to advertising providers for posting, but viewable by all visitors to the site. This section will be online in April.

Thank- You!

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