Forms for Managing Financial Assistance

Translated Forms

Translated Child Care Financial Assistance Forms 

Attendance Forms

Open DOCX file, 28.03 KB, for Approved Break In Care - January 1, 2022 (English, DOCX 28.03 KB)

Open DOCX file, 20.74 KB, for Excessive Unexplained Absence Warning Notice -- March 1, 2019 (English, DOCX 20.74 KB)

General Forms

Open DOCX file, 29.76 KB, for Third Party Verification Form – June 23, 2021 (English, DOCX 29.76 KB)

Open XLSX file, 34.14 KB, for EEC Subsidy File Checklist – September 30, 2021 (English, XLSX 34.14 KB)

Open DOCX file, 30.26 KB, for Household Composition Form - September 30, 2021 (English, DOCX 30.26 KB)

Open DOCX file, 21.89 KB, for Household Income Statement -- March 1, 2019 (English, DOCX 21.89 KB)

Open DOCX file, 19.1 KB, for Last Day of Employment: Employer Certification -- March 1, 2019 (English, DOCX 19.1 KB)

Open DOCX file, 21.82 KB, for Last Day of Employment: Parent Certification -- March 1, 2019 (English, DOCX 21.82 KB)

Open DOCX file, 20.77 KB, for Non-Payment of Parent Fees Warning Notice -- March 1, 2019 (English, DOCX 20.77 KB)

Open DOCX file, 17.51 KB, for Parent Choice -- March 1, 2019 (English, DOCX 17.51 KB)

Open DOCX file, 23.46 KB, for Parent Contact Information -- March 1 ,2019 (English, DOCX 23.46 KB)

Open DOCX file, 35.42 KB, for Parent Enrollment Confirmation Form – June 2020 (English, DOCX 35.42 KB)

Open DOCX file, 25.92 KB, for Parent Enrollment Confirmation Form Spanish – June 2020 (English, DOCX 25.92 KB)

Open DOCX file, 28.99 KB, for Residency Confirmation Form – July 2, 2020 (English, DOCX 28.99 KB)

Open DOCX file, 18.54 KB, for School Closure Only Form – July 2, 2020 (English, DOCX 18.54 KB)

Open DOCX file, 26.59 KB, for SMI Calculation Sheet -- March 1, 2019 (English, DOCX 26.59 KB)

Denial Notice

Open DOCX file, 25.16 KB, for Denial Notice -- May 1, 2021 (English, DOCX 25.16 KB)

Employment Verification Form

Open DOCX file, 59.54 KB, for Employment Verification Form - September 30, 2021 (English, DOCX 59.54 KB)

Financial Assistance Agreement

Open DOCX file, 25.33 KB, for Financial Assistance Agreement – July 2, 2020 (English, DOCX 25.33 KB)

Homeless Forms

Open DOCX file, 17.44 KB, for Homeless Approval Form -- March 1, 2019 (English, DOCX 17.44 KB)

Open DOCX file, 18.36 KB, for Homeless Residency Survey -- March 1, 2019 (English, DOCX 18.36 KB)

Parent Transportation Request Form

Open DOCX file, 19.79 KB, for Parent Transportation Request Form (English, DOCX 19.79 KB)

Report of Self Employment Earnings Form

Open DOCX file, 75.38 KB, for Report of Self Employment Earnings Form -- March 1, 2019 (English, DOCX 75.38 KB)

Request for Review

Open DOCX file, 29.6 KB, for Request for Review - September 30, 2021 (English, DOCX 29.6 KB)

Self Employment Packet Cover Letter

Open DOCX file, 26.36 KB, for Self Employment Packet Cover Letter - October 13, 2021 (English, DOCX 26.36 KB)

Temporary Change Form

Open DOCX file, 21.05 KB, for Temporary Change Form – July 2, 2020 (English, DOCX 21.05 KB)

Termination Notice

Open DOCX file, 32.84 KB, for Termination Notice - September 30, 2021 (English, DOCX 32.84 KB)

Verification of Disability/Special Need of Child

Open DOCX file, 35.44 KB, for Verification of Disability/Special Need of Child - March 1, 2019 (English, DOCX 35.44 KB)

Verification of Disability/Special Need of Parent

Open DOCX file, 30.1 KB, for Verification of Disability/Special Need of Parent (English, DOCX 30.1 KB)

Open DOCX file, 31.56 KB, for Variance Request: Special Need of Parent Extension - June 1, 2021 (English, DOCX 31.56 KB)

Open DOCX file, 23.18 KB, for Initial Special Need of Parent Cover Letter -- May 1, 2021 (English, DOCX 23.18 KB)

Open DOCX file, 25.79 KB, for Special Need of Parent Renewal Cover Letter -- May 1, 2021 (English, DOCX 25.79 KB)