Application For Families

How It Works

1.

Read the eligibility guidelines one more time.

2.

Complete all forms on this application. Incomplete forms will be red.

3.

You will see a confirmation message if your application was submited.

4.

Our staff will review your application, and contact you for next steps.

Begin Application

1. Parent/Guardian Information

Below, please upload two documents as an image file (JPG, PNG, GIF, etc.) If you are receiving an error and need your documents converted, you can convert them for free at this (third party) website: PDFtoImage

All documents need to be the entire original document with your name and address visible. Include the signature page on leases.

Upload Proof of Identity

(driver's license, photo ID, passport)

Upload Proof of Address

(lease, mortgage, utility bill, cable bill, phone bill)

2. Children Information
3. Child Care Program Information

Please note your child(ren) must already be enrolled in an approved licensed Delaware County child care program before applying in order to be eligible. Funds go directly to the child care center, not the families.

4. Attestations

An attestation is a legal acknowledgement of the authenticity of a document and a verification that proper processes were followed. Please read the following carefully and check each box to attest in order to validate this application.

Please scroll up and review the application and make sure everything is filled in and correct before clicking "Submit". Any incorrect or missing information will delay your application.

​An error occurred, do not close this page.

Scroll through the entire page and correct any forms that are red (including document upload buttons), then click "Submit" again.

If you continue to receive this error, email ccpnpa.org@gmail.com and request an email application.