Child Care Subsidy Scholarship Form

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Child Care Subsidy Scholarship

The Student Government Association provides a Child Care Subsidy for eligible CCA students.

Amount: $200-$300
GPA: 2.5
Criteria: Must have completed 12 credit hours at CCA. Have not been awarded the Child Care Subsidy for more than two semesters (you may still be considered, but priority is given to those who have not previously been awarded).
Funds: Dependent Child Care
Credit Hours: Minimum of 6 credit hours

The following items must be submitted along with your application:

A completed FAFSA form must be on file with the CCA Financial Aid Office
Your Child Care Providers W-9 Form (download a blank form)
A copy of your Child Care Provider's License

Priority deadline – 5:00 p.m. September 25 (Fall Semester) and February 12 (Spring Semester). Applications submitted after the priority deadline will still be considered but will be dependent on the availability of funds. Incomplete applications will not be considered.

Name:
S#:
Address:
City:
State:
Zip:
Phone #:
Student E-mail: (College provided @student.cccs.edu email only).

Are you currently employed?	Full time Part time Not employed
How many children do you have?
What are their ages?	Child 1 Child 2 Child 3 Child 4 Child 5
Are you:	Married Single Divorced

Do you receive child care funding from other sources?	Yes No
If you receive funding, how much do you receive?	(Example: $25 per week, or $150 per month)
If you receive funding, please explain from where

What are your current child care expenses?	(Example: $25 per week, or $150 per month)
Child Care Provider Name:
Child Care Provider Address:
Child Care Provider Phone:

Question: Please briefly describe why you deserve to receive this Child Care Subsidy and how it will help you be successful at the Community College of Aurora. Include any special circumstances, such as financial need or family situations that the selection committee should consider. (Must be 200-300 words)

Other documents: You must provide a copy of your Child Care Provider’s W-9 and License. You can upload them below to finish your application. If you cannot upload these items at this time, please click to submit your application and bring the items to the Office of Student Life by the application deadline.

Upload your Child Care Provider's W-9 here:
Upload your Child Care Provider's License here:

Thank you for completing the Child Care Subsidy application. We look forward to reviewing your submission.

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