www.CanadaChildCareDirectory.com

Order Form- Basic Listing

Please print off this form, fill in the information below and send along with cheque for $ 25.00 (including GST) made out to Canada Child Care Directory and mail to us at PO Box 227, Mill Bay, BC, Canada  VOR 2P0. If you have questions please call us at (250) 715-1219.
** Pricing Information click here
** Please note: for the Premium Listing option ($40 per year)  please click here

REQUIRED PROVIDER INFORMATION (Please fill in as much information as possible. Please print clearly)

FACILITY NAME _____________________________________________________________________________________

CONTACT PERSON _________________________________________________________________________________

OWNER/ MANAGER NAME ___________________________________________________________________________

LOCATION (CIVIC ADDRESS) _________________________________________________________________________

MAILING ADDRESS _________________________________________________________________________________

PHONE (           )  __________________________

FAX (         ) ______________________________

EMAIL _____________________________________  

AGES OF CHILDREN ______________________________

 

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