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Child Care Intake Form


  1. 1. Parent Information
  2. 2. Contact Information
  3. 3. Applicant Information
  4. 4. Children Information
  5. 5. More Information
  • Parent Information

    1. ERC is the licensed child care resource and referral agency that assists families in locating child care in Shawnee, Jackson, Osage, Wabaunsee and Pottawatomie counties. The listings include regulated family child care providers, centers, pre-schools and school-age programs. If you would like assistance in locating openings, ERC is here to help, free of charge. Please fill out the form and send it to ERC, either by mail, fax or e-mail.