Instructions for filling out and returning the

LOCATE Child Care Referral Intake Form.

To fill out the form on your computer:

• Click on the link to open the document
• Save it on your computer
• Use the tab keys to navigate to each shaded area and type in your answers.   The area will expand to accommodate your answer
• To use the checkboxes, either click in the box using your mouse, or type in an "x"

When you have completed to form, please return it to us using one of the options listed below:

OPTION 1

• attach it in an e-mail and return it to kayungel@salisbury.edu
• Please include your name, contact information, how and when you would like us to contact you and any other requests in the body of the e-mail

OPTION 2

• Print out the completed form and fax to:  (410) 543-6655
• Please include a cover sheet with your name, contact information, how and when you would like us to contact you and any other requests you may have.

OPTION 3

• Print out the completed form and mail to us at:

LSCCRC-LOCATE Child Care
Suite 500 East Campus Complex
Salisbury University
Salisbury, MD  21801

• Please include a note with your name, contact information, how and when you would like us to contact you and any other requests you may have.

If you have any questions or need help with the form, please call (410) 543-6650 Monday-Friday 9 a.m. to 5 p.m.