 |
Prospective Parent Tracking Form |
Date of Call ____________________________________
Name of parent(s)_____________________________________________________________
Address_____________________________________________________________________
Phone # (home) ________________________ (Work) ______________________________
Email _________________________________________
Name of child(ren) ____________________________________ Birth date _______________
____________________________________Birth date _____________
____________________________________Birth date _____________
Desired start date for care ____________________________ Rate quoted _______________
Any special interests or needs of child ____________________________________________
How did you hear about my program?
Word of mouth (who?) _________________________________________________________
RCC referral __________
Brochure ____________
Other _____________________________________________________________________
Parent concerns/notes _______________________________________________________
Date interview scheduled ________________________
If parent declined interview, why? ______________________________________________
If I turned down parent, why?__________________________________________________
This handout was produced by Think Small (www.thinksmall.org).
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