CCDF Subsidized Child Care

Through the U.S. Department of Health and Human Services we provide subsidized Child Care Vouchers to more than 50 low-income and working Native American Families.

 

CCDF Subsidized Child Care Program Application

Date *
Date
Name *
Name
Street Address
Street Address
Mailing Address
Mailing Address
Home Phone
Home Phone
Cell Phone
Cell Phone
Work and/or School Commitments
Employer's Address
Employer's Address
Employer Phone Number
Employer Phone Number
Address of School
Address of School
I'm the Only Working Adult in my Home
If you Answerd No Above Please Complete the next Section
Name of Working Adult
Name of Working Adult
Employer's Address
Employer's Address
Employer Phone Number
Employer Phone Number
Child's Information
Please provide us with information about each of your children.
Child's Name
Child's Name
Date of Birth
Date of Birth
Is Your Child Special Needs
Child's Information
Child's Name
Child's Name
Date of Birth
Date of Birth
Is Your Child Special Needs
Child's Information
Child's Name
Child's Name
Date of Birth
Date of Birth
Is Your Child Special Needs