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.
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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

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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 ​​​