1
2
3
4

4-C: Community Coordinated Child Care

Forms

CHILD CARE ASSISTANCE PROGRAM FORMS

Child Care Application: The application is used when initially applying for child care or when a previous child care case is no longer active. The application can be completed online or printed off.

Wage Verification Form: This form is used to verify income for families paid in cash or have just begun a new job and are waiting for two consecutive check stubs.

Evaluation Form: Your input on our services is very important to us. Please take a moment to complete the evaluation and send it to us with your form(s).

Español

Child Care Application-Spanish: La alicación se utiliza cuando alguien inicialmente aplica para cuidado de niños o cuando un caso de cuidado de niños anterior ya no está activa. La solicitud puede ser completada en el internet o imprimirse.

Formulario De Verificación De Salario: Este formulario se utiliza para verificar los ingresos de las familias que les pagan en efectivo o acaban de comenzar un nuevo trabajo y están a la espera de dos talones de cheques consecutivos.

Formulario De Evaluación: Su opinión sobre nuestros servicios es muy importante para nosotros. Por favor tome un momento para completar la evaluación y enviarlo a nosotros con su forma.

FOOD PROGRAM FORMS

Enroll in the Food Program

Provider Direct Deposit

Physician Statement for Food Substitution

Parent Request for Non-Dairy Milk Substitute

Providers Applying for Tier 1 by Income

Parent/Guardian Application

TRAINING PROGRAM FORMS

CPR/First Aid Funds for CCAP Providers Only

Reimbursement application and guidelines for individuals – This is for providers who have registered for a training as an individual

Reimbursement application for centers who have taken the training as a group – This is for center programs who arrange an instructor to provide a group training

No announcement available or all announcement expired.