Exemption Self-Assessment

New exemption categories (Categories_Chart.pdf.) The self-assessment for each type of program that will be operating. Complete the following information if applicable, to determine if the program can self-assess or apply for an exemption or license.

Contact Information
Current Exemption Number*(if applicable)
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Exemption Category*(if applicable)
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Program Information
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Program Street Address
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Ownership Information
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Operating Details
Months of Operation
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Days of Operation
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Ages of children served
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Weekday Hours
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Weekend Hours
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Summer Hours
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Additional Hours
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