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CFC-Child Care Tuition Grant Application

CFC-Child Care Tuition Grant Application

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Application for needs based child care assitance for U-M affilated parent/guardians with children enrolled at one of the U-M Children's Centers (Health System Children's Center, North Campus Children's Center or Towsley Children's House)

Application Status

New

For more information regarding the Child Care Tuition Grant, please see the Knowledge Base article "U-M Child Care Tuition Grant (CCTG) Information and Frequently Asked Questions" at https://teamdynamix.umich.edu/TDClient/224/Port...

Important instructions regarding income documentation

You must provide documentation of the income you report in this application as well as any other requested documents by attaching files in the attachments field below.

It will expedite the processing of your application if you assist us by using decriptive names for your uploaded files. For example, when uploading the first two pages of your income tax return you might name it "yourname_tax_return".

A list of required documentation is included just above the attachments field below.

Requestor/Parent/Guardian Information

Preferred Email (if not your UMICH email)

We'll contact you via your UMICH address. If you prefer we use a different address, please enter that here.

Requestor's/Applicant/Parent/Guardian1 U-M Affilation

Visiting Scholar Verification

I understand I need to attach a letter from my dept. verifying my U-M visiting scholar affilation.

Have you applied for the Child Care Subsidy (CCS) through the U-M Office of Financial Aid?

Students eligible to apply for the Child Care Subsidy (CCS) must do so prior to applying for the CCTG. If awarded the CCS, the amount of your CCTG may be adjusted.

Have you applied for the Child Care Subsidy (CCS) through the U-M Office of Financial Aid?

Yes

What is the status of your Child Care Subsidy (CCS) application?

Pending a decision (please notify us when you have received a decision)

Approved, I am or will be receiving the CCS

Denied, I will not recieve the CCS

Please indicate the reason you believe you do not qualify for the Child Care Subsidy (CCS)?

My spouse is not employed or enrolled in a degree granting program at least half time (20 hrs/wk)

I am not enrolled in classes this semester.

My child will not be enrolled in licensed care a minimum of 75% of this semester.

Other, please explain below.

Please explain why you did not apply for the Child Care Subsidy.

Requestor/Parent/Guardian1's uniqname

Requestor/Parent/Guardian1's UMID number

Street Address

City

State

Zip Code

Primary Phone Number

Is there another parent/guardian in your household?

Family Profile

Parent/Guardian 2 First Name

Parent/Guardian 2 Last Name

Parent/Guardian 2 U-M Affiliation

Please indicate the number of adults (18 yrs. & older) in your household:

Please indicate the number of children (under 18 yrs.) in your household:

How many of your chilldren are or will be enrolled at a U-M Children's Center to receive the grant, if you are eligible?

If more than 3, please indicate 3, include their information below and we will get information regarding your other child(ren) from your children's center registration.

How many of your chilldren are or will be enrolled at a U-M Children's Center to receive the grant, if you are eligible?

Child(ren)'s Profile

Child's First Name

Child's Last Name

Child's Enrollment Status

Child's Enrollment Start Date (mm/dd/yyyy)

Child's Center

2nd Child's First Name

2nd Child's Last Name

2nd Child's Enrollment Status

2nd Child's Enrollment Start Date (mm/dd/yyyy)

2nd Child's Center

3rd Child's First Name

3rd Child's Last Name

3rd Child's Enrollment Status

3rd Child's Enrollment Start Date (mm/dd/yyyy)

3rd Child's Center

Household Income

Report GROSS amounts for the previous six months for yourself and, if applicable, the other parent/guardian in your household in each of the following categories. Enter $0 if you did not have any income in a category. For income catagory definitions, please see the the Knowledge Base article U-M Child Care Tuition Grant (CCTG) Information and Frequently Asked Questions at https://teamdynamix.umich.edu/TDClient/224/Port...

***if you are currently receiving the grant and have been asked to reapply for the new academic year, please report income from January 1 through June 30 of this year.

Please note that if you are applying while on the waitlist, an updated application will be required with the most recent six month's income if you are offered enrollment.

Please list the six months for which you are reporting income.

Start date: (mm/dd/yyyy)

End date: (mm/dd/yyyy)

Requestor/parent/guardian's Gross Income, including tips, for the past six months, if none, please enter $0

Parent/guardian 2's Gross income, including tips, for the past six months, if none, please enter $0

A note about transitioning income: If you anticipate your income in the coming months will differ significantly from your past six month's income, please complete the form at https://umich.qualtrics.com/CP/File.php?F=F_cYK... and include it in the attachments to this Child Care Tuition Grant Application.

Unemployment Compensation (Unemployment benefits, WIC, etc.), if none, please enter $0

Awards, scholarships (DHS, CCN, etc.), gifts or non-taxable income, if none, please enter $0

Child Support received, if none, please enter $0

Alimony received, if none, please enter $0

Income from Rents, Royalties, Trusts, Etc., if none, please enter $0

U-M Child Care Subsidy, if none, please enter $0

Any other income not listed above, if none, please enter $0

Total Household Income (add all the lines above)

Did you reside in the U.S. during any part of 2023?

Yes

If you were a resident of the U.S. during 2023 but were not required to complete a Form 8843 or an income tax return, please explain why below:

Documentation

Please upload the following documents in the "Attachment" field below:

PLEASE NOTE: Before uploading documents, PLEASE BLACK OUT OR REMOVE any personally identifiable information (PII) such as social security numbers, taxpayer identification number, or financial account numbers.

1. First two pages of your most recent income tax return (2023) or Form 8843. This is required if you resided in the U.S. during the previous calendar year. If you were not required to complete an income tax return or Form 8843 for 2023, please complete the question above. (suggested file name "tax_return-yourname")- please remember to black out any personally identifiable information

2. Paystubs for the most recent two months of income for the requestor (first parent/guardian) if any income is reported. (suggested file names "yourname_paystub1", your name_paystub2", etc.) please remember to black out any personally identifiable information

3. Paystubs for the most recent two months of income for second parent/guardian if any income is reported. (suggested file names "2ndparentname_paystub1", 2ndparentname_paystub2", etc.) please remember to black out any personally identifiable information

4. If you reported that you did not have income over the past six months, please upload a signed personal statement explaining the source and amount of funds you will have available to support your family while you are at the University of Michigan. This may include any or all of the following: savings, family support, expected gifts, loans, support from your employer or country, or any other funding sources. Please include the dates or approximate amount of time you will depend on the funds. We may request additional documentation after reviewing your statement. (suggested file name "yourname_alternate_income_documentation")

5. If you are a visiting scholar, please upload a letter from your U-M department verifying your U-M affilation. (suggested file name "yourname_visiting_scholar_verification")

6. If your past six months income is not reflective of your anticipated income going forward, attach a completed Transitioning Income Form available at https://umich.qualtrics.com/CP/File.php?F=F_cYK... (suggested file name "yourname_transitioning_income")

Attachment

File attachments associated with the ticket.

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Acknowledgements

It is my responsibility to report any changes in my U-M enrollment or employment, my family income or size, or other circumstances that materially affect my financial situation within two weeks of the change. I may be asked to submit a new application and may become ineligible for further funding.

I understand and agree

I certify that all responses and attachments in this application are complete and accurate to the best of my knowledge and intentional misrepresentation may result in my obligation to repay any funding I have recevied.

I understand and agree

Income Tax Acknowledgement

If I receive a grant, I understand associated taxes may be withheld from my U-M paycheck.

In partnership with CEW+, we are happy to be able to provide a limited number of preschool (3-5 yrs) spaces with additional funding. If you are interested in applying, please select yes below and answer the additional questions.

Yes, I am a U-M student parent/guardian of a preschooler (3-5 yrs) and would like to apply

Yes, my partner/spouse is a U-M student, we have a 3-5 yr old and would like to apply

No, I am not a student, my child is not a preschooler or I am not interested

Which of the following best describes your living situation?

Single parent/guardian living with my child(ren)

Single parent/guardian living with my parent(s)

Single parent/guardian living with family other than my parent(s)

Living with partner/spouse and co-parenting

Other, please describe below

If you answered "other" above, please provide a description here.

Are you receiving support (financial or caregiving) from family members or other individuals for child care?

Yes

Please describe the support (financial or caregiving) you receive from family.

What level are you?

Undergrad- First Year

Undergrad- Sophomore

Undergrad- Junior

Undergrad- Senior

Undergrad- Year 5 or more

Graduate- Year 1

Graduate- Year 2

Graduate- Year 3

Graduate- Year 4

Graduate- Year 5 or more

How many credits do you plan to take fall term?

How many credits do you plan to take winter term?

How many credits do you plan to take spring term?

How many credits do you plan to take summer term?

What is your residency status for paying your U-M tuition?

In-state student

Out-of-state student

Are you an international student?

Yes

Where will you live?

On campus

In Ann Arbor within walking distance to campus

In Ann Arbor as a commuter

Outside of Ann Arbor

If my child(ren) are selected for the CEW+ spaces and funding, I agree to complete a program survey once every two months.

I agree

I do not agree

Other Fields

Your name

Your first name

Your last name

Your email address

Verification Code