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 Connection Point at 1-800-676-2805.

Forms on the site can be downloaded without issue using the Internet Explorer browser. If you experience trouble, please visit by opening Internet Explorer.

For all browser options, a PDF reader program will be required to view and print forms. The free Adobe Acrobat Reader can be downloaded here:

If you are using the Google Chrome browser:
At the “Please Wait” error page, you can choose to download the PDF by clicking the download button… it is a downward pointing arrow, ending at a line. You can then open the file in your installed PDF reader program.

Mozilla Firefox will automatically download these documents, so make sure to check your downloads after  you click on the form.

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 need a form regarding a change in childcare provider, change in information, wage verification, or redetermination, please call Community Connection Point at 1-800-676-2805 *




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
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