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Your full legal name:Your birthdate: Home phone:(REQUIRED) Email Address:Work phone:Home Address:City, State Zip: Name of Child Care you work in:Please circle which type of child care you work in: Licensed
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How to fill out your birthdate

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To fill out your birthdate, follow these steps:
02
Start by writing the day of your birth in numerical format. For example, if you were born on the 15th, write '15'.
03
Next, write the month of your birth using either the numerical format or the full name of the month. For example, if you were born in January, you can write either '01' or 'January'.
04
Finally, write the year of your birth using four digits. For example, if you were born in 1990, write '1990'.
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Make sure to enter your birthdate accurately and double-check your entries before submitting.

Who needs your birthdate?

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Various entities may require your birthdate for different purposes, including:
02
- Government agencies for official records, identification, or age verification.
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- Employers for employment or background checks.
04
- Financial institutions for account creation or verification.
05
- Healthcare providers for medical records or age-related treatments.
06
- Educational institutions for enrollment or age verification.
07
- Online services for age restrictions or personalized experiences.
08
It is important to provide your birthdate only to trusted entities and be cautious about sharing it online or with unknown sources.
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My birthdate is November 25th, 1990.
I am required to file my own birthdate.
You can fill out my birthdate by entering the date, month, and year in the designated fields.
The purpose of my birthdate is to provide information about when I was born.
The information that must be reported on my birthdate includes my date of birth and possibly the place of birth.
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