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FINANCIAL AID CHILDCARE ASSISTANCE FORM

The Federal Government supports the Childcare Access Means Parents in School (CCAMPIS) Program in helping provide funding for childcare costs through federal financial aid. This program is designed to assist eligible student parents in paying for childcare.

In order to determine your eligibility, please complete this form that will allow the Financial Aid office to obtain information (household size and income). It is important to complete all sections of this form. Failure to do so will delay processing and eligibility determination.

Student Name(Required)












List only the children in your household, who will require childcare.(Required)
First Name
Last Name
Age
 

Please read and agree to the following acknowledgements