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FOR NEW HAMPSHIRE LICENSED PLUS QUALITY RATING CHECK TYPE OF APPLICATION: NEW PROGRAM NAME: ADDRESS (Actual location) TOWN: RENEWAL (EVERY 3 YEARS) FEDERAL ID # DAYTIME PHONE NUMBER STATE: ZIP: MAILING ADDRESS (If different) NAME OF FAMILY CHILD CARE PROVIDER E-MAIL ALTERNATE PHONE NUMBER INSTRUCTIONS: It is mandatory that you document compliance with the eleven required standards, which are highlighted and marked with an asterisk * in the left hand column. In addition, select and d.

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