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Interest Form

Join the family care providers dedicated to creating the best early learning environments.

Send Us Your Inquiry to Join ELSSA

Your Name(Required)

First Last

Position (ex. Director)(Required)

Name of Childhood Education Center(Required)

Email(Required)

Phone(Required)

Your Address(Required)

Street Address Address Line 2 City ZIP Code

Operation Number (Enter 000 if unavailable)(Required)

Select all offered:(Required)

Full-day care

Part-time care

After-school program

Please select all that apply:(Required)

Child Care Licensing licensed provider

Child Care Licensing registered provider

We are actively working toward Texas Rising Star Certification

Texas Rising Star 2-Star

Texas Rising Star 3-Star

Texas Rising Star 4-Star

Phone

This field is for validation purposes and should be left unchanged.

1. Full Name

2. Your Role (Title)

3. Your Email

4. Phone Number

5. Name of Childhood Education Center

6. City

7. State

8. Zip Code

9. Address

10. Would you like to join Shared Services Alliance?

Yes No

11. Center Capacity

12. Is your center currently Texas Rising Star certified?

Yes No

13. What ages does your center serve?

14. Is your center currently partnering with any other agencies?

Yes No

15. If yes, please type what partnering agencies your center works with:

The Early Learning Shared Services Alliance (ELSSA) is a powerful network of child care centers and child care providers dedicated to creating the best early learning programs. ELSSA is powered by Pre-K 4 SA.

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