AdvantagePlusAgency.com - Request for Childcare

Office Hours:
9AM-5PM PST

Corporate Office :
22048 Sherman Wy, #303
Canoga Park, CA 91303

ORDER CENTER - REQUEST FOR CHILD CARE

We look forward to providing excellent child care for you and your family.

Please fill out our online form to request Child Care. Fill out all the appropriate fields that you know the answers to. You will recieve a call within 48 hours to reconfirm the data sent and one of our placement counselors will get back to you and discuss rates and services plans.

If this is for a group event babysitting or hotel babysitting, you may view our standard rate sheet by click on the link here. ALL of our caregivers have CPR, First Aid and TB tested, have had a background check and have had their references checked.

We serve most of the major hotels in the Los Angeles area.

Todays Date:

Todays Time:

Order Taken by::

Counselor:

How did you hear about us?:

Referred by::

Job Discription:

Parents Data

First Name:

Last Name:

Day Phone:

E-mail Address 1:

Parents Billing Address

Line 1:

Line 2:

City:

St./Prov.:

Zip:

Country:

Name of Child1:

Age:

Name of Child2:

Age #2:

Name of Child3:

Age #3:

Location of Service:

Line 1:

Line 2:

City:

St./Prov.:

Zip:

Country:

Comments:

Comment1:

Date to start Service:

End Time:

Start Time::

(Entered by office only) Rate:

CC Type:

CC Number:

CC Expire:

CC Security# or Billing Zip:

Credit Card Name:

Caregiver:

Call Us Now And Get
The Help You Need!

800 687 8066

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NOTICES: PRIVACY POLICY | SUBSCRIPTION AGREEMENT | EULA | AUP....................................................................COMMENTS & SUGGESTIONS

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