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Provider Account Registration
Help with SSN or EIN:
Regulated providers use the last four digits of either the EIN or SSN associated with your child care license. Relative providers use the last fours digits of your SSN.
Your Information
(Required fields are in
bold
)
First Name
Last Name
Email Address
Confirm Email Address
Password
Confirm password
Facility Information
License Number
Regulated Providers' Last 4 of EIN or SSN
(Licensed centers, licensed homes or registered homes)
OR
Relative Providers' Last 4 of SSN
Account creation was unsuccessful. Please correct the errors and try again.
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