Program Forms & Documents

The following items are resources for each of our programs and services. For parents and child care providers who participate in our programs, please consult with a Program Specialist about which forms are required of you. If you would like to have a document or form mailed to you, or if you have any questions about these items, please contact your local CHS office.

Child Care Eligibility List (CCEL)

Eligibility Questionnaire

Child Care Payment Program (CCPP) and Family Child Care Home Education Network (FCCHEN) – For Families

Family Participation Handbook
Family Participation Handbook - Acknowledgement of Receipt
Child or Spousal Support Affidavit
Declaration Form
Declaration Form (Employment)
Declaration Form - Reduction
Declaration Form (In-Home Provider)
Domestic Services Employment Verification
Educational Program Verification
Employment/Income Verification
Participation Requirements – At Risk
Participation Requirements – Child Protective Services
Participation Requirements – Educational Program
Participation Requirements – Employment
Participation Requirements – Homelessness
Participation Requirements – Parental Incapacity
Participation Requirements – Seeking Employment
Participation Requirements – Seeking Permanent Housing
Participation Requirements – Vocational Training
Record of Income
Release and Hold Harmless Agreement
Statement of Homelessness Need
Statement of Parental Incapacity
Statement of Seeking Employment
Statement of Seeking Permanent Housing
Training Verification
Verification of Self Employment/Independent Contractor


Child Care Resource and Referral Program (R&R)

Child Care Referral Policy
Choosing Child Care Brochure
Complaint Policy
Parental Choice Brochure

Family Education Program (FEP)

Family Education Program Material Request Form

Informational Letter

Informational Letter to Active Families and Providers

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Areas of Interest


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