Child Care Resource and Referral at John A. Logan College Back to JALC

Forms

The following forms are available to download and print from our web site. You will need to have Adobe Reader installed on your computer to access and use these files. Click here to download Adobe Reader.

Forms may take a minute to download please be patient.

Child Care Assistance Program (CCAP) Forms

Families can request forms for the Child Care Assistance Program (CCAP) using our Online Request form.

Online Request Form

In addition, the following forms are available to download and print from our web site. You will need to have Adobe Reader installed on your computer to access and use these files. Click here to download Adobe Reader.

Forms may take a minute to download please be patient.

Forms should be mailed to: CCR&R 700 Logan College Rd. Carterville, Illinois 62918.

Before mailing,

  • make sure they are complete in full, are signed and dated
  • make sure they are completed in ink
  • Do not use white out

ONLINE APPLICATION

IDHS also offers an online application at http://www.dhs.state.il.us/page.aspx?item=68333 All CCAP forms and supporting documentation can be submitted directly into the system via e-mail at DHS.CCMS-PRD@ILLINOIS.GOV. It is always a good idea to call our office 24 hours after submitting your online application to insure we have received it. Supporting documentation such as paystubs, wage verification forms, schedules, class schedules and grades should be mailed directly to CCR&R or can me emailed to ccrr@jalc.edu. Items sent via email cannot be photos from your phone as these images cannot be scanned into our system.

Forms are unavailable at this time. Please continue to check this website frequently or contact Nina Wargel at 800-548-5563. Thank you.

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