BuildUp Oregon: Child Care Provider Project Interest

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Welcome, and thank you for your interest in BuildUp Oregon!

This interest form should be completed by either the Owner or Director of the Early Care & Education Program, or someone authorized to apply on their behalf.

If your plans include more than one project (Ex: Requesting Renovation/Repair for 2 locations under the same business) you will be allowed to enter information for up to 3 locations. Please be prepared to designate one project as a priority over the others.

Por favor siga este enlace para acceder a este formulario en español.

BuildUp Oregon: Interés en el proyecto de proveedores de cuidado infantil

Please review and acknowledge the following information:

Yes, I am the Owner/Director of the Child Care Facility Yes, I am authorized to apply on behalf of the Owner/Director

Yes, I understand that this is an initial Interest Form to gauge eligibility and is not the application for funding

Yes, I understand that if I am eligible and approved for funding (after the application process) that any Grant Award(s) received are fully taxable by the IRS

Now, let's confirm that you are at the right stage of the BuildUp process before we make you fill out any unnecessary information!

Please respond accurately so we can provide resources to get you on the right path if you're not eligible just yet.

Have you applied and been accepted as a Multnomah County Preschool For All (PFA) Provider?

YesYes, but my program is not yet licensedNoNot yet, but I am planning to apply

Are you applying for one project only or for multiple projects? (3 max)

One project onlyMultiple projects

Great! Now let's clarify your goals for each project.

Please enter information for each project separately
Please designate one project only as the priority (top left checkbox) in the event we are unable to accommodate all projects

(Please note that you are limited to 3 project entries)

⭐ Prioritize this project

Please classify the project:

Child Care Provider seeking to open a New Child Care Center (Family Child Care ineligible)Child Care Provider seeking to Renovate and/or Repair an Existing FacilityChild Care Provider planning to co-locate with a new Affordable Housing ProjectDeveloper of an Affordable Housing Project seeking to open a new Child Care Provider Facility

Please identify the Facility Certification type of your project

Child Care Center (CCC)Family Child Care (FCC)

Is opening the New Facility contingent upon acquiring property?

Yes, and I have acquired the propertyYes, but I have not acquired the propertyNo

Would you be interested in partnering with an Affordable Housing Developer? (Please note that a yes response gives us permission to share your information with Developers seeking a partner Provider for their project)

Yes!

In what Oregon county is your Existing Facility located for the Renovation and Repair Project?

In what Oregon county will your New Facility be located?

This Renovation/Repair project is for my primary Child Care Business (not a subsidiary business)(Check the box only if true. You will enter the Name and Address on the next page)

Facility Name

Note: If your project does not have an established street address at this stage, please skip the Street Address field. Only enter the City and the Zip/Postal Code (of the intended project location)

Project Site/Location Street Address (existing or planned)

City

State

ZIP/Postal Code

Please provide a detailed description of this project:

➕ Add Another Project

Administrative - Do Not Edit/Delete

Facility	Type
GrantOutcome1	OFN1

⭐ Prioritize this project

Please classify the project:

Please identify the Facility Certification type of your project

Child Care Center (CCC)Family Child Care (FCC)

Is opening the New Facility contingent upon acquiring property?

Yes, and I have acquired the propertyYes, but I have not acquired the propertyNo

Yes!

In what Oregon county is your Existing Facility located for the Renovation and Repair Project?

In what Oregon county will your New Facility be located?

This Renovation/Repair project is for my primary Child Care Business (not a subsidiary business)(Check the box only if true. You will enter the Name and Address on the next page)

Facility Name

Project Site/Location Street Address (existing or planned)

City

State

ZIP/Postal Code

Please provide a detailed description of this project:

➕ Add Another Project

Administrative - Do Not Edit/Delete

Facility	Type
GrantOutcome2	OFN2

⭐ Prioritize this project

Please classify the project:

Please identify the Facility Certification type of your project

Child Care Center (CCC)Family Child Care (FCC)

Is opening the New Facility contingent upon acquiring property?

Yes, and I have acquired the propertyYes, but I have not acquired the propertyNo

Yes!

In what Oregon county is your Existing Facility located for the Renovation and Repair Project?

In what Oregon county will your New Facility be located?

This Renovation/Repair project is for my primary Child Care Business (not a subsidiary business)(Check the box only if true. You will enter the Name and Address on the next page)

Facility Name

Project Site/Location Street Address (existing or planned)

City

State

ZIP/Postal Code

Please provide a detailed description of this project:

Administrative - Do Not Edit/Delete

Facility	Type
GrantOutcome3	OFN3

Unfortunately, based on your project location, this project is ineligible at this time.

BuildUp's Multnomah County PFA Facilities funds are limited to programs located in Multnomah County

and by participating as a Qualified Provider in Preschool for All

To stay up-to-date on Program Announcements, sign-up for the BuildUp Oregon Newsletter!

Unfortunately, based on your response, your project is ineligible at this time.

BuildUp's Multnomah County PFA Facilities funds are limited to programs located in Multnomah County

and by participating as a Qualified Provider in Preschool for All

Apply to become a Qualified Preschool For All Provider

Once you become a qualified PFA Provider, we welcome you to resubmit an interest form.

To stay up-to-date on Program Announcements, sign-up for the BuildUp Oregon Newsletter!

Based on your response, you likely accessed the wrong application.

BuildUp's Multnomah County PFA Facilities funds are limited to Child Care Providers.

BuildUp has a separate program for Developers of Affordable Housing Projects planning to co-locate with a Child Care Provider.

Please follow this link and click the button labeled 'Developers'

To stay up-to-date on Program Announcements, sign-up for the BuildUp Oregon Newsletter!

Congratulations! Your project(s) has been established as being (potentially) eligible to receive Multnomah County PFA Facility Funding

Now we need to collect some basic information about you and your business so we can follow up

New Center Project

While infrequent, it is possible that a New Center Project may coincide with establishing a New Child Care Business (ie - you do not have an existing child care business.)

Please help us understand your specific situation by answering the following:

Please identify your situation:

I have an established primary child care business, and my project is creating a subsidiary locationI do not have an established child care business (or it is in-progress), and my project is also creating my primary business

Please check off any items your new Child Care Business has established:

I have a physical street address for my child care businessI have a Child Care License NumberI have a State Business Registration NumberI have an EIN (Employer Identification Number)

Business and Licensure Information

Please enter information for your current Child Care Business.

If you have multiple facilities, please enter information for your Primary Child Care Business

Registered Child Care Business Name (or, intended name if not yet registered)

(As it appears on the Oregon Secretary of State Business Registry)

Business Street Address

City

State

ZIP/Postal Code

Enter your Child Care License Number (As it appears on your Child Care License)	State Business Registration Number (As it appears on the Oregon Secretary of State Business Registry)
EIN (Employer Identification Number)

My primary Child Care Business (above) has multiple subsidiary facilities in operation(Check the box only if this statement applies to your business)

Please enter the Child Care License Number(s) for each Child Care Facility in operation within Multnomah County

Enter each license # on a new line

Applicant Contact Information

First Name	Last Name
What best classifies your role at this organization?	Role

How can we reliably reach you?

Please enter an email that you check frequently, prioritizing a work email address, if possible.

Email

Phone

Applicant Demographics

We collect demographic information so we can better understand the clients we serve and the impact we have on the community. Your responses are not used as decision-making criteria and do not impact your eligibility.

Your demographic data will always be reported anonymously. If you are uncomfortable sharing any of this information, please simply select "Prefer Not to Answer."

Race	Other Race

Ethnicity

Other Ethnicity

Primary Language

Attestation

Please acknowledge the following statements:

The information provided on this form is true and complete to the best of my knowledge

I understand the BuildUp Oregon team may contact me to provide clarification before moving forward with the application process

Thank you for your interest in BuildUp Oregon!

Someone from the BuildUp Team will review your submission. You will receive a copy at the email address provided. We look forward to learning more about your project!

Please remember to click 'Submit' (and wait for the confirmation screen) before closing the browser window

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