Program Provider Number Request

This form is intended only for businesses or higher education entities that want to request background checks on their employees (ex: bus drivers, substitute teachers) or students prior to working at or being placed in a child care program through the Child Care Provider Portal (CCPP) . Prospective child care providers should follow the process outlined on the Starting a Licensed Child Care page if they wish to become regulated.

You need a provider number in order to gain access to the Child Care Provider Portal (CCPP) and submit requests for background checks. Fill out this form to obtain a provider number.

Please note: Some higher education entities may already have a provider number because they operate a licensed child care program. You will use the same provider number, but will need a new location number to request background checks for students placed at other child care centers for their practicum. Please fill out this form to obtain a new location number for your program. Do not use the licensed child care program's CCPP account information to submit background check requests for practicum students.

Location Address
Mailing Address

Contact Person - The contact person should be the primary contact at the business or higher education entity who can be contacted pertaining to the child care background checks.

Contact Information