Aspire Childcare Scholarship Application Form
Infant/Toddler Childcare
Child's Name
*
First Name
Last Name
Child's Date of Birth
*
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent's Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Parent Name
*
First Name
Last Name
I understand that these scholarships are available only to students who will be in infant or toddler childcare, and that my child must be registered or on the waitlist by the scholarship application deadline to be considered. Funds awarded will be applied directly to the selected childcare center or provider.
*
Yes
What is your working situation? (Parent A)
*
Work full time
Work part time
Currently, not working
What is your working situation? (Parent B)
Work full time
Work part time
Currently, not working
N/A
What is your monthly household income? (All adults living in your home). Please provide a tax return to verify income and dependents.
*
Do you have other children? If so, please enter in their ages.
children
Which Infant/Toddler Childcare Provider Do you Wish to Use?
Wings Early Childhood Center
Tiff's Little Cubs Childcare
Teresa Mael (In-Home)
Jana Carter (In-Home)
What type of childcare do you need?
*
Part time
Full Time (4-5 days per week)
What is your living situation?
*
Married
Living with Partner
Single
Live with other family members
What parenting or group classes have you attended at Aspire?
*
classes
Why do you need this scholarship? What will happen if you do not receive any funding towards childcare?
Do you qualify for Colorado Child Care Assistance Program (CCCAP) ?
*
Yes
No
I don't know
I understand that this scholarship is contingent upon my child maintaining a minimum attendance rate of 80% and adherence to the guidelines set forth by the Child Care Provider I choose.
Yes
I understand that the deadline to submit this application and any other required materials is November 1, 2024, and that late or incomplete applications will not be considered.
*
Yes
I affirm that the information on this form, the essay(s), and any other required materials is accurate and complete.
*
Yes
Parent Signature
Date
-
Month
-
Day
Year
Date
Submit
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