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Serving children and families since 1971

Phone: 304-414-4488

Art Class

Provider Forms

Tiered Reimbursement Applications

Tiered Reimbursement Application for Facilities

Tiered Reimbursement Application for Centers

Tiered Reimbursement Application for FCCs

Attendance Sheet

Request for Pay Form

Provider Notice to Agency

Emergency Info Forms

Child Medical Form

Incident Report Form

Emergency Phone List

Medication Permission Form

Direct Deposit Form

FACTS PLUS

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