Child Care Assistance Program Forms | Community Connection Point

Child Care Assistance Program Forms


Please read through the list of forms below, to find the one that bests fits your needs as a parent or provider.

If you have any questions about any of these forms, please contact us at 1-800-676-2805 and someone will be available to assist you.

If you are needing a Redetermination, Change of Provider, Add/Delete Family Member or Wage Verification form, please contact Community Child Care Connection, Inc. to request the necessary form


Child Care Assistance Application

Complete this form if you are a new applicant or if your child care case has been cancelled for over 30 days. Please also download the Application Checklist to help ensure timely processing of your application.


 E-mail Agreement

To receive e-mail notices of case updates-parents must sign-up for these updates. You may sign-up for e-mail notification by completing this form


Letter of Employment Requirements Form

Your employer will need to complete this form if you have been employed less than 30 days and/or are unable to submit 2 current, consecutive and complete check stubs.


Self-Employment Records Form

If you have been self-employed less than one year and have not yet filed income taxes 3 full months of self employment records may be completed.


Attention: The below form is for a change in your address.

Client Change of Address Form


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