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Get Mo 580-2994 2020-2026

USUALLY LEAVE EACH DAY VARIATIONS IN USUAL ATTENDANCE IN THIS SECTION INCLUDING SHIFT CHANGES. MON AM PM TUES WED THURS FRI SAT SUN MO 580-2994 1-12 PLEASE ALSO COMPLETE PAGE 2. MISSOURI DEPARTMENT OF HEALTH AND SENIOR SERVICES SECTION FOR CHILD CARE REGULATION / BUREAU COMMUNITY FOOD NUTRITION ASSISTANCE CHILD CARE ENROLLMENT FORM FACILITY/PROVIDER NAME ADMISSION DATE DISCHARGE DATE CHILD S NAME GENDER BIRTHDATE ADDRESS STREET CITY STATE ZIP IDENTIFYING INFORMATION MOTHER S/GUARDIAN S NAME HOME PHONE CELL PHONE E-MAIL EMPLOYER OR SCHOOL ATTEND WORK/SCHOOL SCHEDULE WORK PHONE EMERGENCY CONTACT AND PERSONS AUTHORIZED TO TAKE CHILD FROM FACILITY OTHER THAN PARENT AT LEAST ONE EMERGENCY CONTACT IS REQUIRED. NAME RELATIONSHIP TO CHILD PHONE NUMBERS CELL WORK HOME COMMENTS ON CHILD S DEVELOPMENT NOTE CHILD S PERSONAL DEVELOPMENT BEHAVIOR PATTERNS HABITS AND INDVIDUAL NEEDS RELATED CHILD HOW IS CHILD RELATED TO CHILD CARE PROVIDER YES NO CACFP REQUIREMENT CHILD S PROJECTED ATTENDANCE SCHEDUL....

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How to fill out the MO 580-2994 online

Filling out the MO 580-2994 form can be straightforward with the right guidance. This document is crucial for enrolling a child in a child care facility, ensuring all necessary information is accurately provided.

Follow the steps to complete the MO 580-2994 form online.

  1. Click ‘Get Form’ button to obtain the MO 580-2994 document and open it in your preferred online editor.
  2. Start filling out the top section with the facility or provider name, admission date, and discharge date. Ensure that all written information is clear and correctly spelled.
  3. Provide identifying information for the child, including their name, gender, and birthdate, followed by the address details (street, city, state, ZIP code).
  4. Enter the mother’s or guardian’s information, including their name, telephone number, email address, and employer or school details. If the information is the same as above, check the indicated box.
  5. Repeat the process for the father’s or guardian’s information, ensuring to include the same type of contact and employment details.
  6. List at least one emergency contact who can take the child from the facility if necessary. Provide their relationship to the child and contact information.
  7. In the comments section, note any relevant information about the child’s development, behavior patterns, and individual needs.
  8. Indicate your child's projected attendance schedule by checking the appropriate days of the week and specifying arrival and departure times.
  9. Select the meals your child is usually given at the facility by checking the applicable options.
  10. Review the authorization for emergency medical care section, ensuring that emergency contacts and preferred facilities are accurately listed.
  11. Acknowledge the facility's policies by reviewing them and providing your initials in the necessary sections.
  12. Finally, sign and date the form in the designated areas for the parent or guardian. Ensure that all information is accurate before submitting.
  13. Once completed, save your changes, download the form, print it if necessary, or share it as needed.

Start the process of completing the MO 580-2994 online today!

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