Forms for Child Care Assistance Program 

Please click on any of the links below to download the PDF form that you need. If you have questions about any of these forms, please contact Community Child Care Connection at 217.525.2805.

Complete this form if you are a new applicant or if your child care case has been cancelled for over 30 days.

Your employer will need to complete this form if you have been employed less than 30 days and/or are unable to submit 2 current, consecutive and complete check stubs.

If you have been self-employed less than one year and have not yet filed income taxes, three full months of self-employment records should be completed.

If you have any questions, please call the Community Child Care Connection forms hotline at 217.525.2805 (Option 2, Option 1)

Phone

Office Hours

901 South Spring Street, Suite B
Springfield, Illinois 62704
M, T, Th, F: 8:00 am - 4:00 pm
Wednesday: 8:00 am - 2:00 pm

Serving the Illinois counties of Christian, Logan, Macoupin, Mason, Menard, Montgomery, Morgan, Sangamon and Scott.

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© 2020 Community Child Care Connection