Home
Administration
Administration - Home
Feedback
Contacts
Financials
Procurement
Board
Board - Home
DNSSAB Board
NDHC Board
TWOMO
Children's Services
Children's Services - Home
Licensed Child Care
Become an ECE
Child Care Fee Subsidy
EarlyON Child & Family Centres
EarlyON Child & Family Centres - Home
EarlyON - North Bay & Area
EarlyON - West Nipissing
EarlyON - Rural & Remote Areas
Parent Resources
Providers Hub
Providers Hub - Home
Quality & Inclusion
Professional Learning
Program Guidelines
Funding Guidelines
Funding Guidelines - Home
WEG/HCCEG
CWELCC
Workforce Compensation
Professional Learning Funding
Non-Discretionary Funding
Additional Resources
Questions/Feedback
Contacts
Expression of Interest
Reports
Housing Services
Housing Services - Home
Community Housing
Homelessness
Homelessness Prevention
Homeowner Programs
Housing Development
Northern Pines
Contacts
Reports
Our Departments
NDHC
NDHC - Home
Tenant Services
Tenant Services - Home
Forms
F.A.Q
Maintenance
Contractors
How to Apply
NDHC Board
Contacts
Feedback
Ontario Works
Ontario Works - Home
Benefits
OW Forms
FAQ
Contacts
Reports
Feedback
How To Apply
Paramedic Services
Paramedic Services - Home
Paramedic Services
Community Paramedicine Program
Volunteer EFRT
Feedback
Contacts
Media
Data Portal
Data Portal - Home
Data Portal Home
Ow Data Portal
Children Services Open Data
Housing Open Data
Paramedic Services Open Data
General Demographics Open Data
Open Data Feedback
Careers
EN
FR
Search
Home
Children's Services
Providers Hub
Program Guidelines
Fee Subsidy Confirmation of Space Form
Fee Subsidy Confirmation of Space Form
Fee Subsidy
Confirmation of Space Form
Please complete this form when placing a child whose parent/guardian has requested Child Care Fee Subsidy.
This information is collected under the legal authority of the Child Care and Early Years Act, 2014 for administering the programs and services prescribed or authorized under this Act.
Yes, I give permission to store and process this data
Child Care Site Information
Name of Child Care Centre/Site
Name of Staff completing the form
Email of staff completing the form
Parent Information
Parent/Guardian Name
How many children are being placed?
1
2
3
4
Child 1
Name
DOB
Effective Start Date
Program Age Category
Infant
Toddler
Preschool
JK/SK
School Age
Family Grouping
Care Times Required (check all that apply)
Before School
After School
PD Day
Breaks
Care Days Required (check all that apply)
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
According to work schedule
Child 2
Name
DOB
Effective Start Date
Program Age Category
Infant
Toddler
Preschool
JK/SK
School Age
Family Grouping
Care Times Required (check all that apply)
Before School
After School
PD Day
Breaks
Care Days Required (check all that apply)
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
According to work schedule
Child 3
Name
DOB
Effective Start Date
Program Age Category
Infant
Toddler
Preschool
JK/SK
School Age
Family Grouping
Care Times Required (check all that apply)
Before School
After School
PD Day
Breaks
Care Days Required (check all that apply)
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
According to work schedule
Child 4
Name
DOB
Effective Start Date
Program Age Category
Infant
Toddler
Preschool
JK/SK
School Age
Family Grouping
Care Times Required (check all that apply)
Before School
After School
PD Day
Breaks
Care Days Required (check all that apply)
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
According to work schedule
Comments (optional)
Please confirm that you are not a robot.
Form
Recaptcha Response