Child Care Services Forms
After School Program Enrollment Certification CD-9608A (PDF)
Annual Summary of Eleven- and Twelve-Year-Old Children in Early Education and Support Division Child Care Programs CD-9608Bx (XLS)
Annual Summary of Eleven- and Twelve-Year-Old Children in Early Education and Support Division Child Care Programs CD-9608Bx (DOC)
Attendance and Fiscal Reporting forms are available through
the Child Development Fiscal
Services Web site.
Calendar Fiscal Year 2017-18 EESD-9730 (XLS)
Calendar Fiscal Year 2018-19 EESD-9730 (XLS)
Calendar Fiscal Year 2019-20 EESD-9730 (XLS)
Child Care Data Collection Privacy Notice and Consent Form CD-9600A (DOC)
Available Translations of the Child Care Data Collection Privacy Notice and Consent Form
CDD-801A and CDD-801B Child Development Data Reporting
Child Ratio Schedule CD-3705 (DOC)
Confidential Application for
Child Development Services and Certification of Eligibility EESD-9600 (DOC)
Available Translations of the Confidential Application for Child Development Services and Certification of Eligibility EESD-9600
Desired Results Materials and Forms
Emergency and Identification
Information CD-9607 (DOC)
Available Translations of the Emergency and Identification Information
Enrollment and Attendance
Register CD-9400 (DOC) Requires 11 x 17 paper.
Equipment Inventory EESD-8604 (PDF) Requires Legal paper.
Equipment Purchase Approval CD-2703 (PDF)
Health and Safety Training Expenditure Report CD-5004
Income Calculation Worksheet - Cash, Wages, or Salary CD-ICW (DOC)
Notices of Action
Notification and Certification for 11 and 12-Year-Old Children CD-9608 (DOC)
Available Translations of the Notification and Certification for 11 and 12-Year-Old Children
Out of State Travel CD-2700 (DOC)
Parent Plan for Seeking Employment EESD-PPSE (PDF)
Prekindergarten and Family Literacy Program (PKFLP) Site Change Request and Eligibility Form CD-PKFLP (DOC)
Program Narrative Change FY 2015-16 EESD-3704A (DOC)
Program Narrative Change FY 2016-17 EESD-3704A (PDF)
Program Narrative Change FY 2017-18 EESD-3704A (PDF)
Resource and Referral Program Service Data Report
The online data report (CD 2504E) completed by Resource and Referral contractors and instructions on how to obtain a contractor’s password and how to complete the data report.
Site Supervisor or Program Director Staffing Qualifications Waiver Request EESD-7701A (PDF)
Site Supervisor or Program Director Staffing Qualifications Waiver Extension Request EESD-7701B (PDF)
Statement of Incapacity CD-9606 (DOC)
Available Translations of the Statement of Incapacity
Training Verification-Parent or Caretaker Attending School or Receiving Training EESD-9605 (DOC)