COVID-19 First Responders Child Care Survey
This CHILD CARE survey is dedicated to those who are first responders or essential services (Schneck employees, City: Police, Fire, Transit; County: EMS, Sheriff, Jail, & County Hwy) in the midst of the COVID-19 situation unfolding. We are asking questions now so that in partnership with those who need to serve, we may be able to find a way to meet the needs of child care support.

Please complete the survey completely to give us the best idea of how to prepare.
 
1.

I am employed at: 

City of Seymour
County of Jackson
Schneck Medical Center
Other  
2.

Age of Child(ren) as of March 23, 2020 

0-12 Months
1-2 Years
2-3 Years
3-5 Years
5-12 Years- Elementary School
13+ Years- Middle & High School
3.
How many child(ren) in each age bracket above and total?   (ie: 1- 1-2 year old and 2- 5-12 year olds; 3 total)
 

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4.
I need child care to start at: (on a typical rotation)
 

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5.
I need child care to end at: (on a typical rotation) 
 

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6.

Days of the Week, I need child care: 

Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
SUnday
7.

My child care would need to be in: 

Brownstown
Crothersville
Medora
Seymour
I'm willing to drive within the county for child care in this emergency.
8.

My child(ren) have special needs, here are my concerns or what we would need addressed: 

 

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9.

Other Concerns: 

 

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10.

Enter your email: 

 

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