Follow the steps to complete the PA CY 868 application online.

1. Click 'Get Form' button to obtain the form and open it in the editor.
2. Provide your personal information. Enter your first and last name, address, and contact details. If experiencing homelessness, check the appropriate box.
3. Indicate if you receive any benefits such as TANF or SNAP. Answer 'Yes' or 'No' as applicable.
4. List all members of your household, including their relationship to you, date of birth, and racial/ethnic identity.
5. Detail your children in need of child care, including their citizenship status and the days they require care.
6. Certify your child's immunizations status and provide additional details about their health or educational background, if applicable.
7. Complete the employment, education, and training section by confirming your employment status and detailing your schedule.
8. Outline your household income and expenses, ensuring to provide proof for any claims made.
9. Provide permissions regarding the sharing of your application with other early learning programs.
10. Review the rights and responsibilities section. Acknowledge and confirm your understanding by filling in the affidavit with your signature and date.
11. Once completed, ensure you save changes and consider downloading or printing the form for your records. Submit your application by mail, fax, or in-person to the local ELRC office.

Complete your PA CY 868 application online today to receive the assistance you need.