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 one of the below forms, please contact Community Child Care Connection, Inc. to request the necessary form.


Change of Provider

Change of Information

Wage Verification

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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