Before you can submit your application, you will have to upload a clear photo or copy of each required document listed below:

Required Documents

- Birth Certificate
- Insurance Card
- Proof of Income (1 month of recent pay stubs from each parent OR W-2s)
- Health Screening
- Immunization Record
- Proof of Residency (Only required if your child will attend Junction City)

I give my consent to the Director of the facility, or the representative, for said child to receive medical or surgical aide as may be deemed necessary and expedient by a duly licensed or recognized physician or surgeon in case of an emergency when the parents cannot be reached. Consent is also given for the Director or duly appointed representative to transport said child for emergency medical treatment if the parents can not be reached.

I declare under the penalty of perjury and the rules and regulations of the Arkansas Better Chance program that the information supplied is true and correct at the time of application. I understand that the information I supplied may be independently verified by the Arkansas Division of Child Care and Early Childhood Education and that any false statements may result in exclusion from DHS programs and criminal prosecution.

Please click on the buttons below to download the documents: