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Submit Provider Information

Please complete the Provider Enrollment form and send it to the Office of Work, Life and Engagement. You may email or fax the form, however, the original must be mailed to our office at 1101 E. 33rd Street, Suite C100, Baltimore, MD 21218.

Provider Enrollment Form

When the Provider Enrollment form is received, the Office of Work, Life and Engagement will verify that the dependent care provider fits one of the following:

  • State licensed child care center
  • State licensed family child care provider
  • Program sponsored by Johns Hopkins University
  • State licensed adult day care center
  • State licensed home care provider

The provider must be licensed or certified according to state regulations. A copy of the provider's license must be included with the enrollment forms.

If your child attends the Johns Hopkins Child Care and Early Learning Center (Bright Horizons), Harry and Jeanette Weinberg Y Preschool Journeys program, or the Downtown Baltimore Child Care Center, you do not need to submit verification of the center's license.

 


Updated 05/02/2014