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How many children are in your house hold?
   
 
 
 
Do you think that the proposed location of the daycare is a good area for a childcare facility?
   
 
 
 
Is there anyone in your household in need of WIC or MPS services?
   
 
 
 
Do you feel it's a good idea to offer family counseling with daycare services?
   
 
 
 
Would you need transportation for your children?
   
 
 
 
What are the hours that your would need childcare?
   
 
 
 
What services do you feel are important when looking for a childcare facility for your (child)ren?
   
 
 
 
Do you feel that a child care center that services special needs would be an asset to the community?
   
 
 
 
What are the ages of your children?
   
 
 
 
Are there any children in your household with special needs?
   
 
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