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Mile High United Way's physical office is currently closed, but all of our services including 2-1-1 will be running at full capacity. Please dial
2-1-1
to reach our community resource center.
Colorado Shines Child Care Referral
Licensed Child Care Request
Information About Parent/Legal Guardian
Parent/Guardian Name
*
Have you contacted us in the past?
*
Yes
No
Unsure
Email address (to send the list of licensed child care providers)
*
Telephone Number
*
County of residence
*
Adams
Alamosa
Arapahoe
Archuleta
Baca
Bent
Boulder
Broomfield
Chaffee
Cheyenne
Clear Creek
Conejos
Costilla
Crowley
Custer
Delta
Denver
Dolores
Douglas
Eagle
Elbert
El Paso
Freemont
Garfield
Gilpin
Grand
Gunnison
Hinsdale
Huerfano
Jackson
Jefferson
Kiowa
Kit Carson
La Plata
Lake
Larimer
Las Animas
Lincoln
Logan
Mesa
Mineral
Moffat
Montezuma
Montrose
Morgan
Otero
Ouray
Park
Phillips
Pitkin
Prowers
Pueblo
Rio Blanco
Rio Grande
Routt
Saguache
San Juan
San Miguel
Sedgwick
Summit
Teller
Washington
Weld
Yuma
Home Address
*
Street Address
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Search for child care around this address?
*
Yes
No
If searching for child care in a different area, please include full address below
Street Address
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Information About Children
If child is not yet born "unknown" may be entered under name and the child's due date may be entered in place of birthdate.
Child's First Name
*
Child's Birthdate
*
MM slash DD slash YYYY
Date child care is needed
*
MM slash DD slash YYYY
Child's First Name
Child's Birthdate
MM slash DD slash YYYY
Date child care is needed
MM slash DD slash YYYY
Child's First Name
Child's Birthdate
MM slash DD slash YYYY
Date child care is needed
MM slash DD slash YYYY
Child's First Name
Child's Birthdate
MM slash DD slash YYYY
Date child care is needed
MM slash DD slash YYYY
For any additional children, please include their information in the text box below
(name, birthdate, date child care is needed)
Search Information
Please let us know about your child care needs
Are you receiving financial assistance to help pay for child care?
*
CCAP
TANF
None
Please select the days you need child care
*
Select All
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Please specify child care start time
*
:
Hours
Minutes
AM
PM
AM/PM
Please specify child care end time
*
:
Hours
Minutes
AM
PM
AM/PM
Type of licensed care desired
*
Child Care Center
Family Child Care Home
Preschool
School Age Care
Special Needs
Social Emotional Behaviors
Respiratory Illness
Diabetes
Seizure Disorders
Physical Delays/Limitations
Food/Dietary
Medical/Special Procedures
Cognitive Delays
Speech/Communication
Extra Care Services
24 Hour
After School
Before School
Drop In
Temp/Emergency
Transportation (to and from school)
If transportation is needed, please include the name of school child attends.
Note: A Child Care Navigator can do a search within a 2-3-mile radius of your child’s school to find you child care providers with the greatest likelihood of offering transportation. Once you have your referrals, you can call and speak to providers about whether transportation may be available.
Would you like to share additional information about your child care needs?
Optional Demographic Information
The questions below are not required, but if you decide to answer them, it will help us serve our community better.
Relationship to Child
Relationship to Child
Mother
Father
Grandparent
Guardian
Other Relative
Case Manager
Parent/Guardian Age
Parent/Guardian Age
Under 20 Years of Age
20-29 years of Age
30-39 Years of Age
40-49 Years of Age
50-59 Years of Age
60-69 Years of Age
70 Years of Age or Older
Gender
Gender
Male
Female
Other
Annual Household Income
Annual Household Income
$0 - $10,000
$10,001 - $25,000
$25,001 - $50,000
$50,001 - $75,000
$75,001 - $100,000
$100,001 - $250,000
Greater than $250,000
Total Family Size
Please enter a number from
2
to
20
.
Single Parent Household
Single Parent Household
Yes
No
Referred by
Referred by
Department of Human Services
Internet
Print Media
Employer
Other
Reason for Seeking Care
Reason for Seeking Care
Asked to leave
Better quality
Change in work schedule
Child needs
Cost too high
Current care ending
Dissatisfied
Employment
End leave of absence
Maternity leave
Parent Needs
Refused
Relocation
Special needs
Substance use disorder
Training
Other
CAPTCHA