Change in Provider Information

Complete this form regarding a change of address, phone number, or name. If there are any changes to your childcare certificate or license, such as the type of regulation, address, name change, capacity, age range of children cared for, hours of operation, and/or days of operation, you MUST submit a copy of your new certificate or license to the WECA Food Program or fax it to 866-222-9520.

Food Program Change in Provider Info

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