Follow the steps to successfully complete your application

1. Press the ‘Get Form’ button to access the application form and open it in your preferred document editor.
2. Begin by filling out the Parent or Guardian Information section. You will need to provide your last name, first name, middle initial, Social Security Number, and date of birth. Additionally, indicate your race and marital status.
3. Next, you will be required to provide your physical address and mailing address. Include your city, state, and ZIP code for both addresses.
4. Provide your preferred phone and any additional contact number. Also, include a valid email address for communication purposes.
5. Proceed to the Employer/School/Training Information section. Here, detail your current employment or educational institution, including the name, phone number, title of your position, address, hire date, and hours worked or attended.
6. If you are working two jobs or are in school while employed, fill out the additional Employer/School/Training Information fields.
7. Move on to the Child(ren) Needing Child Care section. List each child who requires care, providing their last name, first name, middle initial, Social Security Number, date of birth, race, relationship to you, and whether they attend school.
8. In the Child(ren) Not Needing Care section, list any children or dependants that do not require care, filling in the same necessary details as before.
9. Complete the Household Income section by listing all sources of income. You must provide documentation for each income source listed.
10. Finally, review the Parent/Guardian Statement. By signing, you confirm the accuracy of the information provided and acknowledge the responsibilities outlined in the statement. Ensure to date your signature.
11. After filling out the form, you can save your changes, download, print, or share the completed application as needed.

Complete your Child Care Assistance Application online today to access the support you need.