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Strengthen and Support 
Children and their Families

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If you would like to read about our child care referral service, please click here


 

 Child Care Links Email Referral Request
Please note: Child Care Links assists parents seeking child care by providing referrals and information on available child care options.  Child Care Links does not make recommendations because parents are the ones best able to assess which care situations meet their children’s needs.  It is the parents’ responsibility to screen, interview, and select their child care. Child Care Links offers referrals for the following areas:  Dublin, Livermore, Pleasanton and Sunol.

Please provide the following contact information: (Note: All fields in RED are required information)

First Name
Last Name
Home Phone
Work Phone
FAX
E-mail

Which city would you like child care in:

Are you a Subsidy or CalWORKS client:

 

Do you need care near:

 

Based on the previous question, please provide the address, city,  zip code and major cross streets:

 Address:

 

City:

 

Zip code:

 

Please provide us with your nearest major cross streets:

  &                                                  

Please enter all information regarding your child:

Name or initials:

(Not required)

Date of birth:

  -- mm/dd/yy                             

Enter the date that you would like to begin care:

  -- mm/dd/yy

Will the child be in kindergarten when they need care?

 

Hours that care is needed: (0:00am - 0:00pm):

 

Please indicate what days that care is needed:
(Mon, Tue, Wed, Thurs, Fri)

 

Schedule of care requested:

 

Week Schedule (Optional)

 

Day Schedule: (Optional)

 

Type of care (Please select all types of care you will consider). To select more than one option hold your "CTRL" key and left mouse click each option to select:

 
**Please note that care for an infant under 2 years old in a 
Child Care Center is very limited in Pleasanton and Dublin.
Child Care Links does NOT offer referrals to Nannies or other type of 
unlicensed care providers that come to your home.

Please provide additional information if "Other" is selected from above?


Note: Please read your ADA Rights (Americans with Disabilities Act)  before completing the information below:

Does your child have special needs:

 

If you would like to be referred to an Inclusion Coordinator, please provide any pertinent information below:

What school does the child attend (school age children only)

Do you need the provider to provide transportation to and from school:

 

Do you use public transportation:

 

Do you prefer a provider that is walking distance to your child's school:

 

Second Child Information, if applicable:

Name or initials:

(Not required)

Date of birth:

-- mm/dd/yy                             

Enter the date that you would like to begin care:

-- mm/dd/yy

Will the child be in kindergarten when they need care?

 Hours that care is needed: (0:00am - 0:00pm):

Please indicate what days that care is needed:
(Mon, Tue, Wed, Thurs, Fri)

Schedule of care requested:

Week Schedule (Optional)

Day Schedule: (Optional)

Type of care (Please select all types of care you will consider). To select more than one option hold your "CTRL" key and left mouse click each option to select:

 
**Please note that care for an infant under 2 years old in a 
Child Care Center is very limited in Pleasanton and Dublin.
Child Care Links does NOT offer referrals to Nannies or other type of 
unlicensed care providers that come to your home.

Please provide additional information if "Other" is selected from above?


Note: Please read your ADA Rights (Americans with Disabilities Act)  before completing the information below:

Does your child have special needs:

 

If you would like to be referred to an Inclusion Coordinator, please provide any pertinent information below:

What school does the child attend (school age children only)

Do you need the provider to provide transportation to and from school:

 

Do you use public transportation:

 

Do you prefer a provider that is walking distance to your child's school:

 

Please enter your relationship to the child:

 

Who referred you to our agency website:

 

Reason for seeking child care:

 

Do you have any specific information about providers that you
would like included in your referrals. (i.e. meals, education, training, pets, curriculum)

 

Statistical Information (Optional):

The following information assists Child Care Links with reporting to our funding sources.  Child Care Links does not disclose the names of clients or their children. This is information is confidential.

Your employment status:

Please enter your family 
size (include parents and children)

Are you single head of household:

Please provide your Race/Ethnicity:

Child Care Links
Copyright © 2002-2008. All rights reserved.
Revised: July 18, 2008