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Child Care Wait List Assessment

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  • Income Eligibility Requirements

     

    Family Monthly Income Guidelines 

     

    Income Eligibility Guidelines – 10/01/2022 – 9/30/2023

    Family Size 85% SMI Monthly Income Range Gross Amount
    2 $4276
    3 $5283
    4 $6289
    5 $7295
    6 $8301
    7 $8490
    8 $8679
    9 $8867
    10 $9056
    11 $9245
    12 $9433
  • Documentation will be required for EACH selected priority groups.
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    Select all options that apply to you.
  • Complete information on each child needing care
    Child Name Child Social Security Number (optional) Child’s Gender Child is a U.S. Citizen / Legal Immigrant Child has a disability Child’s Date of Birth  
               
    • Edit
    • Delete
    There are no Children.

    Maximum number of children reached.

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