The Department of Public Health and Human Services, Early Childhood and Family Support Division (ECFSD), is providing limited, one-time scholarships of up to $2,000 per eligible child to working families of elementary-age children (children entering first grade through children entering fifth grade) to help cover the cost of out-of-school time summer programming or care for the summer months. This opportunity is made possible by the Coronavirus Response and Relief Supplemental Appropriations Act (CRRSA). ECFSD anticipates 2,500 scholarships to be awarded across the state. To ensure equitable opportunity for funding across the state, applications will be awarded following a regional allocation formula based on census information. To be considered eligible, parents must be employed and be able to provide documentation of summer care or summer program arrangements. There will be a follow up survey sent in August to the email provided in this application. The survey will be used to help inform the impact of the out-of-school time scholarship.
Household Information

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* 1. Parent/Guardian Information:

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* 2. Physical Street Address:

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* 3. City:

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* 5. Zip Code:

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* 6. Mailing Address (if different than physical address):

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* 7. Primary Phone Number:

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* 8. Email Address (Awarded applicants will receive a survey at the end of summer):

Employment Information

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* 9. Parent/Guardian #1 Employment Information

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* 10. Parent/Guardian #2 Employment Information

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* 11. If either parent is not working, or if a single parent is not working, please explain the need for assistance:

Child Information
Please fill out the following section with information for eligible children in your household (children entering first grade through children entering fifth grade).

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* 12. Total number of eligible children

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* 13. Child's Name

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* 14. Child's Name

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* 15. Child's Name

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* 16. If you have more than 3 eligible children in your household, please provide the same information as asked above:

Program Information

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* 17. Name of Out-of-School Time Program/Provider:

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* 18. If you are using more than one out-of-school time provider, please list them here:

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* 19. Select Type of Program (check all that apply for your eligible children)

Once your application has been processed, and if your application is selected for a grant, you will be asked for verification of enrollment.
Financial Information

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* 20. What is your total monthly cost of out-of-school time care?

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* 21. Does your family/child currently receive the Best Beginnings Child Care Scholarship?

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* 22. Does your family receive any other financial assistance/scholarships for out-of-school time programming?

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* 23. Are you applying for the full scholarship amount for the eligible children in your household?

Certification

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* 24. Please certify the following:

Before submitting your application, please make sure you have answered every question. Incomplete applications will not be accepted.

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