Child Care Benefits



In order for us to determine your eligibility (or ongoing eligibility) for child care services, we must have the following information or verifications:

1) Last 4 check stubs or employer statements indicating hourly rate and number of hours worked per week. (Must include each adult member in your household.)

2) Copy of a work schedule or an employer's statement showing days and times worked. (Must include each adult member in your household.)

3) Copy of a official school schedule (if attending school).

4) Provide the name of the child care provider(s) you have selected.

5) Complete and return the JFS_1138_Child_Care_Apllication_Form.

6) If you are interested in other child health care services complete and return the
Child Care/Healthy Start/Healthy Families Supplement.

7) Complete and return the Authorization for Release of Information for your EMPLOYMENT and/or SCHOOLING.

8) Complete and return the Rights and Obligation package.

*NOTE: If this is a new application or a redetermination please check to make sure that EACH item on the child care application form is completely filled out. While a face to face interview is not required to apply for child care services any blank or incomplete section on your application may result in an interview being scheduled to review those items. If you have any questions or would like to have a face to face interview please feel free to contact the Social Services unit at (740) 373-5513.