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4C's of Alameda County

Online Child Care Referral Request Service

Welcome to 4C’s Online Referaral Request Service.  If you are looking for child care in southern Alameda County* and would like a listing of child care providers who may be able to meet your needs, please complete and submit the form below.  We will process your request within 3 business days or contact you for follow-up information. Please read 4C's referral policy.


You may also contact our child care referral specialists at 510-582-2182.  Our referral hours are Mondays, Wednesdays, Thursdays  , Tuesdays and Fridays .


* Southern Alameda County includes the cities of Castro Valley, Fremont, Hayward, Newark, San Leandro, San Lorenzo and Hayward.  Our service can provide a listing of child care providers located within a specified area anywhere in southern Alameda County.

 

First Name
required field
Last Name
required field
Home Address
required field
Home City
required field
Home Zip Code (5 Digits)
required field
Work Address
required field
Work City
Work Zip Code
Home Phone
required field
Work Phone
Cell Phone
Fax Number
Email Address
required field
Best time to reach you
Morning
Afternoon
Best telephone number to reach you at
Home
Work
Cell
You are the?
Mother Father Relative Other
What language would you like the child care provider to speak?
What type of child care are you looking for?
required field
Why are you looking for childcare?
Does your child have a special need?
If Yes, Please Explain
Where do you need your child care to be near?
required field
Two (2) major cross streets where care is needed
Number of children needing child care?
required field
Date of Birth of Child(ren)
Days of the week care is needed
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Drop Off Time
required field
Pick Up Time
required field
Do you need your child taken to school?
Do you need your child picked up from school?
Name Of School
Is your child potty trained?
Do you need help to pay for your child care?
How did you hear about us?
How would you like to receive your list of child care referrals?
required field
Additional Comments
required field = Required