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Resource & Referral Forms

Form # Title
Critical Care Child Care Parent Agreement
Critical Care Child Care Assistance Status Check
Critical Care Family Application
CRITICAL CHILD CARE MEMO
EXECUTIVE ORDER: STAY HOME
CRITICAL CHILD CARE APPLICATION for providers
CRITICAL CHILD CARE DIRECTIONS
Needs Assessment 2019
Instructor Academy Requirements 2019
Academy Application 2019
Monthly Nomination 2019
ECE-CC-1E Status Check 11/2018
Link FACT Sheet 102018
Provider Request for Technical Assistance Form
ECE-CC-10A Child Care Provider Request for Payment
ECE-CC-1 Application for Child Care Services
Confidentiality Statement for the FACTS Plus Application
FACTS PLUS Application
FACTS Direct Deposit Setup
Training Needs Assessment
ECE-CC-10F Provider Notice to Agency
ECE-CC-1B New Employment Verification
ECE-CC-0162B Change of Information
ECE-CC-10D Child Care Parent Fee Notice
ECE-CC-10G Child Care Attendance Sheet

Page last updated: Oct 3, 2018

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611 7th Ave - Suite 100
Huntington, WV 25701
Phone: 304-523-9540 or 1-800-894-9540
Fax: 304-697-4821