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SUMMER PROGRAM AUTHORIZATION FORM This form applicable for the summer of 2014 (June August) Student Name Preferred Name Parent(s) or Guardian(s) Information: Name Relationship Employer Wk Hours Wk
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How to fill out CCS extended care:

01
Start by gathering all necessary information and documents required to complete the application. This may include personal identification, income verification, medical records, and any other relevant documentation.
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Carefully read and understand the instructions provided with the CCS extended care application. Make sure you are aware of any eligibility criteria, deadlines, and specific requirements for your state or region.
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Begin completing the application form by providing your personal information, such as your name, address, date of birth, and contact details. Make sure to double-check the accuracy of this information before submitting.
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Next, you will be asked to provide information about the child or children for whom you are seeking extended care. This may include their names, ages or birthdates, medical conditions or special needs, and any specific care requirements they may have.
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Complete the financial information section, which typically includes details about your household income, expenses, and any assistance programs you are currently receiving. Be prepared to provide supporting documents, such as tax returns or pay stubs, to verify your income.
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In some cases, you may need to provide additional information regarding your child's medical condition or disability. This may include medical reports, diagnosis confirmation, and any relevant medical history. Make sure to follow the instructions closely and provide accurate and up-to-date information.
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After completing the application form, review all the information you have provided to ensure its accuracy. Take the time to make any necessary corrections or updates before submitting the application. It is essential to provide truthful and complete information to avoid delays or complications in the processing of your application.

Who needs CCS extended care?

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CCS extended care is intended for families or guardians who have children with special needs, medical conditions, or disabilities that require additional care or support beyond what is typically covered by regular child care services.
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It is designed to assist families who may face financial challenges in accessing high-quality and specialized care for their child. The program aims to provide financial assistance to eligible families, ensuring that their children receive the necessary care and support to thrive.
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Eligibility for CCS extended care may vary depending on the state or region, as each jurisdiction may have different criteria and requirements. Generally, families must meet specific income guidelines and demonstrate a need for extended care due to their child's medical or developmental needs.
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CCS extended care is beneficial for families who may require assistance in covering the costs associated with specialized child care services, such as respite care, occupational therapy, physical therapy, or medical supervision.
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It is essential to research and understand the eligibility criteria and specific requirements for CCS extended care in your state or region. This will help determine if you qualify for the program and guide you through the application process.
Remember, it is always advisable to reach out to the appropriate CCS extended care program or agency for detailed information and guidance to ensure accurate and timely completion of the application process.
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CCS Extended Care is a program that provides additional support and services to children with special medical needs.
Parents or legal guardians of children with special medical needs are required to file for CCS Extended Care.
To fill out CCS Extended Care, parents or legal guardians need to complete the application form with all required information and submit it to the CCS program office.
The purpose of CCS Extended Care is to ensure that children with special medical needs receive the necessary support and services to thrive and improve their quality of life.
Information such as the child's medical diagnosis, treatment plan, healthcare providers, and any other relevant medical information must be reported on CCS Extended Care.
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