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EIU Child Care Resource and Referral

Frequently Used Forms

Families and providers can call or request these forms via email to have a form sent to them. If you have questions, please call our office. 



CCAP Application-The Child Care Application is used when initially applying for child care or when a previous child care case is no longer active.

CCAP Aplicación (Espanol)

Wage Verification Form-A Wage Verification Form is used to verify a parent’s employment (only if pay stubs are not available). 

Self-Employment Record-If you are self-employed, a Self-Employment Record is used to provide us with accurate and complete records of money you take in and the work expenses you pay out. 



W-9-A W-9 form is submitted to the Illinois Department of Human Services Comptroller and the provider must be approved by the State of Illinois to be compensated for services.

Child Care Rate Certification Form-A Rate Certification Form is used by licensed homes/centers/license-exempt centers to document their current child care rates.

Debit MasterCard Payment Option Form-Providers can receive their CCAP payments through an Illinois Debit Mastercard.

Telephone Billing Agreement (IVR system)-A Telephone Billing Agreement allows providers to enter their child care payment through the Child Care Telephone Billing System.

Fingerprint Vendor Information-If you are required to be fingerprinted, this provides information about the fingerprint vendor (locations, times, website, phone number).



Parent Co-Payment Information-Effective 07/01/23

Child Care Payment Rates for Child Care Providers-Effective 12/01/22

CCAP Flyer-Effective 07/01/23

Local CCR&R Illinois Map

Related Pages

Contact Information

CCR&R (Quality, Training, Referrals)

3015 Ninth Street Hall

Office Hours

Monday-Friday: 8:00 am-4:30 pm

Office Closures:

New Year Holidays, Martin L. King Birthday,
Lincoln's Birthday, Memorial Day,
Juneteenth, Independence Day,
Labor Day, Election Day,
Thanksgiving Holidays, Christmas Holidays

Child Care Assistance Program

3015 Ninth Street Hall

Summer Office Hours:

Monday -Thursday: 7:45 am to 4:30 pm
Friday: 7:30 am to 12:00 pm

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