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OFCCA Membership Application
Please fill out this form in it's entirety. If you do not know your house rep or senator, please go to:
http://www.oklegislature.gov/FindMyLegislature.aspx
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Facebook Name
*
Your answer
Name on License
*
Your answer
License Number
*
Your answer
Email
*
Your answer
What is your preferred method of receiving updates?
Facebook
E-mail
Clear selection
Do we have your permission to put your name and contact information on the OFCCA website as a means for other members to contact you?
Yes E-mail only
Yes phone only
Yes, e-mail and phone number
No Thank you
Clear selection
Are you a part of any child care Associations? If so, please list them here.
Your answer
Address
*
Your answer
City / Town
*
Your answer
Zip Code
*
Your answer
Phone number
Your answer
Licensed since...
*
Your answer
Does your family home child care participate in STARS or National Accreditation? ?
STARS
National Accreditation
Other:
Would you like for your child care's information and/or website to be published on OFCCA's website?
Yes
No
Clear selection
If your child care has a website / Facebook page, please type web address below.
Your answer
Oklahoma State House Rep (not US Representative, the State Reps will be listed towards the bottom of the page when you enter your address at
http://www.oklegislature.gov/FindMyLegislature.aspx
)
*
Your answer
Oklahoma State Senator (not US Senator, the State Senator will be listed towards the bottom of the page when you enter your address at
http://www.oklegislature.gov/FindMyLegislature.aspx
)
*
Your answer
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