Client CCAP Forms

The CCC provides CCAP clients access to the following forms to make your application process easier and more efficient.  Below is a list of forms and instructions. Click here to search our CCAP offices to identify where forms should be mailed (search by county, city, etc). 

We strongly encourage you to print the CCAP Application Checklist to assist with your application process.

**Application start date will be determined by the date received in the office or submitted online.

ALL COMPLETED FORMS SHOULD BE MAILED TO OR DROPPED OFF AT YOUR LOCAL CCAP OFFICE.

 Form Name Instructions  Sample Form   Print Form
DCC 90 – Application for Subsidized Child Care Assistance Used To Apply English Spanish
DCC 90I — Work and School Schedule  Used to verify school and work schedule View Sample Form
English Spanish
 DCC 90C — Household and Residency Verification  Used to verify household composition and residency. View Sample Form English Spanish
DCC 90D — Verification of Employment and Wages Used to verify earned income View Sample Form  English Spanish
DCC 91 — Client Rights & Responsibilities  English Spanish
DCBS 1 – Informed Consent & Release of Info & Records View Sample Form  English Spanish
DCC 90.1 — Intent To Apply For Child Care Assistance   English Spanish
DCC 90.1 – Procedural Instructions English
Request for Exemption From a STAR-Rated Child Care Facility English

 



 Please call the CCC at 1-800-809-7076 with any questions.  You can also report changes to your CCAP case by clicking here.

Funded in whole or in part from federal, CHFS, or other state funds