The Licensed Child Care Provider Agreement (Form 2632, 3 pages) is a form submitted by child care providers. All licensed child care providers enrolled through the Department of Health and Human Services to receive payments for providing child care through the Child Care and Development Fund Scholarships must date and sign the agreement upon enrollment.
The provider agreement form includes detailed instructions to assist providers with its completion. When printing this form from the DHHS Website, the provider should make and keep a photocopy. |
