Formulaire de confirmation de placement

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.
Child Care Site Information
Parent Information
How many children are being placed?
Child 1
Program Age Category
Care Times Required (check all that apply)
Care Days Required (check all that apply)
Child 2
Program Age Category
Care Times Required (check all that apply)
Care Days Required (check all that apply)
Child 3
Program Age Category
Care Times Required (check all that apply)
Care Days Required (check all that apply)
Child 4
Program Age Category
Care Times Required (check all that apply)
Care Days Required (check all that apply)