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Child Care Application


You may be eligible to receive child care while searching for work that will meet minimum employment activity.

If you meet the requirements and would like to apply for child care assistance please complete the application below. Your submission will be sent to our team.


To speak to a child care specialist please call 1-800-996-7589 or 325-653-2321.

Submitting this application does not guarantee eligibility. Applicants should expect contact through email or phone call from a CCS representative that will inform you of if you qualify for CCS and whether you will be placed on the wait list. 

This application can be printed and filled out HERE.

Additional Documentation

The following are some of the documents we may ask you to provide in order to complete your application for assistance:

  • Proof of U.S. citizenship or legal immigrant status for each child on whose behalf you request our help with child care expenses (birth certificate, alien registration card I-551, etc.)
  • Proof of income for all working household members, including name, address, and phone number of the employer, work hours/days, rate and schedule of pay
  • Proof of your current school hours and registration that includes documentation of your degree plan (if pursuing one) and your credit/clock hours if you are going to school

Submitted documents will be sent to our child care specialists. Please speak to a child care specialist if you have questions about what documents to submit.

To speak to a child care specialist please call 1-800-996-7589 or 325-653-2321.

Submit Documents Here

CCS Forms

Forms needed to receive child care assistance are listed below. To print a form, click on the form name. The form will be open as a PDF file which can be printed from your computer.