1) Name: 2) Title: 3) Organization: 4) E-Mail Address: 5) How did you hear about the Indiana Child Care Workforce County Data Sheets?: --Select an Option-- Indiana AEYC newsletter/website/mailing Other publication/website Email/Listserv Conference/presentation/workshop Friend or relative Employer or co-worker Child Care Resource and Referral 6) About which county or counties are you interested in obtaining information? (Hold down the Control Key to Select Multiple Counties): --Select an Option-- All counties No specific counties Adams Allen Bartholomew Benton Blackford Boone Brown Carroll Cass Clark Clay Clinton Crawford Daviess Dearborn Decatur DeKalb Delaware Dubois Elkhart Fayette Floyd Fountain Franklin Fulton Gibson Grant Greene Hamilton Hancock Harrison Hendricks Henry Howard Huntington Jackson Jasper Jay Jefferson Jennings Johnson Knox Kosciusko LaGrange Lake LaPorte Lawrence Madison Marion Marshall Martin Miami Monroe Montgomery Morgan Newton Noble Ohio Orange Owen Parke Perry Pike Porter Posey Pulaski Putnam Randolph Ripley Rush St. Joseph Scott Shelby Spencer Starke Steuben Sullivan Switzerland Tippecanoe Tipton Union Vanderburgh Vermillion Vigo Wabash Warren Warrick Washington Wayne Wells White Whitley 7) How might you use information from the County Data Sheets in your community? (Hold down the Control Key to Select Multiple Answers): Share with a local or state representatives Share with Board of Directors Share with local Chamber of Commerce or businesses Educate friends, family, co-workers Grant-writing/Presentations Self-Education

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