Child Care Assistance Program Family Information
Toll Free: 877-855-2227
For your convenience this page will contain links to all of the files you will need to access for Child Care Assistance. (Forms may require Adobe Reader. Download here.)
You may click on the following links, print the files and complete. You may submit any of the forms found on this web page in person, by mail or fax. Please be aware that the Applications are larger files and will take time to download to your computer. Thank you for your patience.
*PLEASE NOTE: new forms uploaded 12/15/15
Application for Alaska Inclusive Child Care
Child Care Assistance Application
Child Support Services Verification Form
Family Contribution Schedule
Family Report of Change
Health Status Report
Monthly Tip Ledger
Self Employment Income Deduction Worksheet
Statement of Support Provided CSSD
Statement of Support Received CSSD
Termination of Child Care Services
Understanding your Authorization
Understanding your Co-Pay
Office: 907-283-4707 FAX: 907-283-4681
Toll Free: 1-877-855-2227 Toll Free FAX: 1-877-855-2230
- Working - or - Attending school/training - or - Looking for Work
- Income Eligibility - the amount of assistance is based on family size and gross monthly income on a sliding fee basis (see "Family Contribution Schedule" below for family size and income detail). Gross monthly income is determined using both earned and unearned income being received by the family.
- Age Eligibility - children up to 13 years of age or children 13 to 19 years of age who have a developmental disability
- Eligible Provider - select a child care provider who is eligible to participate in the Child Care Assistance Program
Alaska's Statewide Child Care Resource and Referral Network, thread, offers referral services to parents needing assistance with locating child care providers.
If you meet the guidelines listed above, you may be eligible to receive assistance with your child care costs. Print the "Family Application" found below. Print, complete, attach required documentation and submit to our office. If you have any further questions regarding eligibility, please contact our office. You may visit the State of Alaska website for an online child care calculator, forms and resources.
- A completed Child Care Assistance Application
- A copy of your government issued photo identification card
- Proof of your family's gross monthly income
- Proof of age for the children who will be receiving assistance.
Office Hours: Monday - Friday 8:00 a.m. - 5 p.m.
We are located on the second floor of the Seaman Building: 601 Frontage Road, Suite 204, Kenai.