CHILD CARE RESOURCE AND REFERRAL
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CHILD CARE ASSISTANCE PROGRAM FORMS

​Families can request forms for the Child Care Assistance Program (CCAP) using our Online Request form.
request forms here
In addition, the following forms are available to download and print from our web site. You will need to have Adobe Reader installed on your computer to access and use these files. 

Click here to download Adobe Reader.
​

Forms may take a minute to download please be patient.
  • Child Care Application Packet - Download both forms. 
    Application,  W-9 form
  • Wage Verification Form
  • W-9 Form - this form is needed for an application and provider change
  • Telephone Billing Agreement
  • Attendance Exemption Request
  • Self- Employment Record
​
Forms should be mailed to: CCR&R 700 Logan College Dr.. Carterville, Illinois 62918.
Before mailing,
  • make sure they are complete in full, are signed and dated
  • make sure they are completed in ink
  • Do not use white out

QUICK LINKS

Finding Child Care
​Paying for Child Care
​ExceleRate Early Learning 
​Developmental Screening
Resources and Links ​​​
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​CCR&R follows John A. Logan College's policies and procedures for emergency closures.

QUICK LINKS

CCR&R Training
Register for Training
Form Request
Online Learning
​FAQ's
​John A. Logan College

OFFICE HOURS

M  W - F
8:00 am – 4:30 pm

T
10:30 am - 4:30 pm


MAILING ADDRESS

700 Logan College Drive
Carterville, IL 62918
Phone: 618-985-5975
​Toll Free 800-548-5563
Fax: 618-985-3528

PHYSICAL ADDRESS

607 S. Greenbriar Road
Carterville, IL. 62918
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© 2021 CCR&R at John A. Logan College. All Rights Reserved.
  • Home
  • Families
    • Finding Child Care
    • Paying for Child Care >
      • income Guidelines
      • CCAP-Easy to Apply
      • CCAP FORMS
      • CCAP - FAQs
    • ExceleRate™ Early Learning
    • Developmental Screening
    • Resources and Links
  • Providers
    • COVID 19 Resources For Providers
    • CCR&R Training >
      • Training Calendar & Registration
    • Online Learning and More
    • Centers and Licensed Homes >
      • Child Care Assistance Program
      • Referrals to Your Program >
        • Updating Program Information
      • ExceleRate™ Illinois
      • The Quality Team
      • Grants and Funding
      • Resources
    • Licensed Exempt Homes >
      • Child Care Assistance Program
      • Health and Safety Training
      • Home Visits
      • Grants and Funding
      • Resources
    • Start Up Information
    • Technical Assistance
  • Communities
    • Data and Reports
    • Community Systems
    • Education and Advocacy
  • About Us
    • The CCR&R Staff
    • Policies
    • Forms
    • Contact