Leading from Home Application 2024 Applications open on April 10, 2024 and close May 15, 2024. Application: Leading from Home 2024 Application for Family Child Care (FCC) providers and Family, Friend, and Neighbor (FFN) caregivers for the Leading from Home initiative of 2024 Name* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Email* Phone*How would you describe the area where you live? Urban Suburban Rural Languages you speak (please check all):* Arabic Chinese English French or French Creole Hindi Korean Spanish Tagalog Vietnamese Other If you selected "Other," please share additional language(s) you speak: What is your preferred language?* Arabic Chinese English French or French Creole Hindi Korean Spanish Tagalog Vietnamese Your gender* Female Male Nonbinary Prefer not to say Your race/ethnicity:* American Indian or Alaska Native Asian or Asian American Black or African American Hispanic or Latinx Native Hawaiian or Other Pacific Islander White or Caucasian Multiracial Your year of birth: How did you hear about Home Grown? If someone referred you, please share with us. These funds are for home-based child care providers and caregivers who lead a group or network of other providers/caregivers in their local communities. (For example: a licensed family child care provider who leads a network of other providers, OR a relative caregiver who regularly organizes a group of other caregivers and parents.)1. Are you currently a home-based child care provider or caregiver?* Yes No 2. I am a:* A Family Child Care Provider (FCC): Also known as Family Child Care Homes or Family Day Care Homes. You provide care out of a private residence, typically as a business. You may or may not be licensed/registered/certified, depending on local regulations. A Family, Friend and Neighbor (FFN) Provider: You provide care for children informally, likely without a license, although these requirements vary by state. You may or may not be paid by the families you care for and may or may not consider yourself a “provider.” 3. How long have you been caring for children?*1 year or lessMore than 1 and less than 5 yearsMore than 5 and less than 10 yearsMore than 10 and less than 20 yearsMore than 20 years4. Which systems do you participate in? (Select all that apply.)* Child and Adult Care Food Program (CACFP) Quality Rating Improvement System (QRIS or QIS) Child Care Subsidy, Child Care Voucher or Child Care Scholarship Early Head Start Head Start PreK (State, County, or City Funded) None of the above 5. Tell us how you connect with other child care providers (check all that apply).* I currently do not connect with any other home-based child care providers I connect informally with between one and four other home-based providers that I talk to regularly to ask questions, share ideas and experiences. I connect informally with five or more other home-based providers that I talk to regularly to ask questions, share ideas and experiences. I participate in an established network or association of five or more home-based child care providers (e.g., your network has named leadership roles, offers services, may or may not collect dues, etc.) I lead an informal group of five or more home-based providers that I meet with regularly to ask questions, share ideas and experience I lead an established network or association of five or more home-based child care providers (e.g., your network has named leadership roles, offers services, may or may not collect dues, etc.) I lead an established network with 501c3 or fiscal sponsorship status (e.g., your organization is eligible for grants) None of the above 6. If you checked any of the above, please share what provider types are in your group or network (check all that apply). Family Child Care (FCC) providers Family, Friend, and Neighbor (FFN) caregivers Center-based child care providers Other 7. Which of the following do you participate in? (Check all that apply) I participate in a Local NAEYC affiliate (National Association for the Education of Young Children) I participate in a Local NAFCC affiliate (National Association of Family Child Care) I participate in a Local NBCDI affiliate (National Black Child Development Institute) I am a member of a union or similar organization (e.g. SEIU, AFSME or other). None of the above Other 8. Are you currently participating or anticipating participating in a provider leadership program outside of Home Growns? If yes, please share the name of the program.*9. Given your current responsibilities, do you have 5-10 hours per month to devote to the Leading From Home initiative?* Yes No 10. Experience as a provider or caregiver: Please share a few sentences about your experience as a home-based child care provider or caregiver. Please include your years of experience, number of children served, ages of children served, and highlights. Tell us what is special and unique about you as a provider or caregiver.*12. Experience of your group of providers and parents: Please share information about your group of home-based child care providers/caregivers and parents, including: When did you begin meeting? How many participants? How often do you meet (in person or online)? What are your activities? Do you currently have support from anyone? If so, who? What type of support would you like? Optional: If your network has experience with policy work, please share that here.*13. Goals of your group or network: What are the goals and needs of your network or group? Please check your top two.* Policy: working with advocates and lawmakers to ensure providers and caregivers are supported by policy, regulation, and funding Equity: Improving equitable access for providers and families (ex. language access, advocating for provider access to public resources, etc.) Access to comprehensive services: connections to additional services for ourselves or families we serve (e.g., screenings, health, mental health, food, or housing supports) Practice and quality: Improving the quality of our programs or caregiving (e.g., access to curriculum, scholarships, professional development) Finances or business sustainability: support with ensuring our programs are financially sound and sustainable. Other 14. If you selected "other" for #13, please share your goals here. 15. What motivated you to apply for Leading from Home? What goal(s) do you hope to achieve during the initiative?*16. Experience as a leader: Please tell us about your role as a leader in your group of providers/caregivers. How long have you participated in your provider/caregiver network or group? What is it that you do? Please describe an accomplishment that illustrates your leadership or how you have brought people together. (Note: this can be an informal leadership role.)*17. What else would you like to share with Home Grown?CAPTCHA