I hereby certify, under penalty of perjury,
that the information that I have provided is true and correct as of this date,
to the best of my knowledge. I authorize CCS Child Care Programs and their
assigns to have access to any and all financial records necessary to verify the
information contained in this application. I agree to notify C-CAMPIS within
ten (10) working days of any changes of circumstances regarding information
contained in this application. I agree to respect and follow all C-CAMPIS
policies and procedures, and complete the C-CAMPIS
program Pre, Post Surveys as required.
I understand
the discount only applies while I’m in self pay status, based on daily rates
(excluding registration fees), and is conditional on verification of my
eligibility requirements at the end of each quarter.
I understand I will be asked to complete the form
FERPA AUTHORIZATION TO RELEASE INFORMATION FROM STUDENT EDUCATION RECORDS and
provide photo ID with my signature to verify my identity. The form will allow CCS to submit information
to the Federal Department of Education CCAMPIS program, funding the child care
discount, including demographics, certificate and degree information, GPA, Pell
grant eligibility and receipt, and any other information required by the grant.
Funding is limited.
Renewal is subject to funds availability and continuation of Pell eligibility
on a quarter by quarter basis. Funds are
distributed on a first come, first served basis, with priority given to eligible
returning students.