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FINANCIAL AID CHILDCARE ASSISTANCE FORM

The Federal Government supports the Childcare Access Means Parents in School (CCAMPIS) Program in helping provide funding for childcare costs through federal financial aid. This program is designed to assist eligible student parents in paying for childcare.

In order to determine your eligibility, please complete this form that will allow the Financial Aid office to obtain information (household size and income). It is important to complete all sections of this form. Failure to do so will delay processing and eligibility determination.

Student Name(Required)












List only the children in your household, who will require childcare.(Required)
First Name
Last Name
Age
 

Please read and agree to the following acknowledgements

I hereby authorize Tidewater Community College to use my financial aid sources, to pay the child charges. I recognize that these charges will be paid after tuition, fees, and bookstore charges. I affirm that my total financial aid awards are sufficient to cover these charges.(Required)
I further understand that these charges will be paid prior to my receiving the remaining balance of my financial aid if applicable. I agree that if my aid is reduced for any reason, and I no longer have sufficient aid to cover these authorized charges, I will assume responsibility and immediately remit payment to the College.(Required)
I understand that I have the right to refuse Tidewater Community College permission to apply my financial aid toward the child charges, and that I may cancel this authorization at any time prior to the charges being paid. If I choose to refuse or cancel this authorization, I will pay these charges personally.(Required)
I understand that purposely providing false information or misleading information could result in ineligibility of the use of federal financial aid funds and potentially incurring debts to Tidewater Community College or the childcare provider for any incurred childcare charges.(Required)