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2. You may wish to try the pre-qualification calculator before completing this application. *Reminder - we still need all the documents required below for a complete application. These documents can be found on the Kids First financial aid page, in the right hand column.
   Childcare Financial Aid
4. Mother's Name
5. Father's Name
7. Mother's email
8. Father's email:
10. Current Address
11. Current Address
13. Mailing address
14. Mailing Address
16. Work Phone
17. Work Phone
19. Cell Phone
20. Cell Phone
22. List all Children:
    Name: Date of Birth: School or Childcare: Days each child is enrolled:
24. Total number of children in the household:
25. Total number of people living in the household:
27. Do own, rent, or have employer paid housing?
    -- Select One --OwnRentEmployer paid housingOther
28. What is your monthly cost for your home?
30. For a complete application, the documents below are required. These documents can be found on the Kids First financial aid page, in the right hand column. **Completion of this application does NOT guarantee that you will receive financial aid.
32. 2021 Federal Income Tax Return - the entire signed return.
33. 2021 W-2's from all employers
34. CURRENT PAY STUB from all employers
35. IF SELF EMPLOYED – current (YTD) Profit/Loss Statement and complete set of 2021 business taxes
37. Child’s proof of legal presence (United States birth certificate or United States passport)
38. Client responsibility agreement – signed & dated
39. Employment verification – filled out by employer- one is required for each job held
40. Child Support Affidavit – if applicable
42. Mother's Employer #1
    Please list the name, address, dates of employment and your gross monthly income from this employer:
43. Father's Employer #1
    Please list the name, address, dates of employment and your gross monthly income from this employer:
45. Mother's Employer #2
    Please list the name, address, dates of employment and your gross monthly income from this employer:
46. Father's Employer #2
    Please list the name, address, dates of employment and your gross monthly income from this employer:
48. Other Income
    Please list any other sources of income for anyone in the household; include child support, alimony, social security, dividends, or other.
50. Falsification of any of the above information, or use of Financial Aid funds for purposes other than described herein, may lead to immediate termination of Financial Aid funding and is punishable under the Colorado Revised Statutes, Section 18-4-401, Theft of Services.
    In providing the above information, applicant(s) declares the same to be voluntarily furnished. Applicant(s) hereby grants the Kids First Board the right to request verification thereof through persons and/or entities disclosed and/or hereinafter disclosed. Applicant(s) declares the above information is true and accurate. Applicant(s) declares that the information on this application is understood by the applicant(s). I authorize Kids First, licensed childcare programs, Human Services (CCCAP) and other necessary agencies to release pertinent information in order to better coordinate services for my child (children).
52. Mother's Electronic Signature
53. Father's Electronic Signature
55. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
57. Date signed:
58. Date signed
Leave This Blank:


60. 1. Receive an email copy of this form.
61. Email address

    This field is not part of the form submission.

62. Submit Submit and Print

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