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Erie County Tuition Assistance Program

Tuition Assistance Application Form

Complete your application online or download the paper version and return it to 
237 Wayne Street, Sandusky, Ohio Attn: Delisa Nelson. Apply today to access child care 
tuition assistance and support your family's needs!

*You will be asked to upload 4 weeks of pay stubs or a letter from your employer on letterhead that confirms the hours and pay rate assigned to you.
Your application is not complete without this informaiton.

Tuition Assistance On-line Application:

Applicant Information

First Name *
Middle
Last Name *
Country
Address Line 1 *
Address Line 2
City *
State/Province *
Postal Code *
Currently Receive Child Care Subsidy Assistance?
Student
First Name *
Middle
Last Name *
Country
Address Line 1 *
Address Line 2
City *
State/Province *
Postal Code *
Currently Receive Child Care Subsidy Assistance?
Student

Parent #1 Work / School / Training Schedule:

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*Verification of the school/training program is required. School Schedule or Training program verification on letterhead will be accepted.

Parent #2 Work / School / Training Schedule:

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-
-
-
-
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-

*Verification of the school/training program is required. School Schedule or Training program verification on letterhead will be accepted.

Wage Earner Information

*Verification of income is required. Pay stubs, and/or written correspondence on employer letterhead by employer listing hours and rate of pay.

Name | Employer / Type of Income | How Often Received? | Gross Income Amount | Date Last Received
Name | Employer / Type of Income | How Often Received? | Gross Income Amount | Date Last Received
Name | Employer / Type of Income | How Often Received? | Gross Income Amount | Date Last Received
Name | Employer / Type of Income | How Often Received? | Gross Income Amount | Date Last Received
Name | Employer / Type of Income | How Often Received? | Gross Income Amount | Date Last Received

Family Information

Name | Relationship to You | Date of Birth | Sex | Note
Name | Relationship to You | Date of Birth | Sex | Note
Name | Relationship to You | Date of Birth | Sex | Note
Name | Relationship to You | Date of Birth | Sex | Note
Name | Relationship to You | Date of Birth | Sex | Note
Name | Relationship to You | Date of Birth | Sex | Note

Additional Household Members:

Name | Relationship to You | Date of Birth | Sex | Note
Name | Relationship to You | Date of Birth | Sex | Note
Name | Relationship to You | Date of Birth | Sex | Note

Child Information - who are you requesting tuition assistance for?

Child #1

First Name *
Middle
Last Name *
Currently on an:
Currently Child is:
Do You Receive Child Care Subsidy?
First Name
Middle
Last Name
Currently on an:
Currently Child is:
Do You Receive Child Care Subsidy?
First Name
Middle
Last Name
Currently on an:
Currently Child is:
Do You Receive Child Care Subsidy?
First Name
Middle
Last Name
Currently on an:
Currently Child is:
Do You Receive Child Care Subsidy?

Days/Hours Child Care Needed: If a school-aged child please note non-public school hours only!

Name | Monday | Tuesday | Wednesday | Thursday | Friday
Name | Monday | Tuesday | Wednesday | Thursday | Friday
Name | Monday | Tuesday | Wednesday | Thursday | Friday
Name | Monday | Tuesday | Wednesday | Thursday | Friday

Current Child Care Arrangements (paid and/or unpaid care)

Country
Address Line 1 *
Address Line 2
City *
State/Province *
Postal Code *

If you are using more than one provider list the name, addresses and costs below.

Country
Address Line 1
Address Line 2
City
State/Province
Postal Code
Country
Address Line 1
Address Line 2
City
State/Province
Postal Code

Please review the following information carefully and sign below

By Signing This Application:

I acknowledge and agree:

  • To the questions on this form and certify that all my answers are correct and complete to the best of my knowledge.  I have uploaded the required pay stubs or a letter from my employer as required.
  • If awarded, the CCRC will contact my current child care provider listed to ensure that the child/ren listed within this application are currently enrolled.
  • I will apply for publicly funded child care benefits if I am found to be eligible.
  • I will report any changes which affect my eligibility to the Tuition Assistance Fund, including changes in family income, hours of employment/training/education, family size and address. I understand that I must report changes within 10 days of the date they occur.
  • Information About Child Care Providers:
    • Parents may select any program that meets their family needs. These programs include centers, family child care homes, child day camps.
    • If you would like assistance with selecting a provider, your CCRC Tuition Assistance Specialist will assist you.
    • The CCRC has a Child Care Directory to assist you in looking for programs that fit your child care needs at www.ccrcinc.com. The directory allows you to search by location, type of program, services offered and days and hours of operation. Information is provided about each program including Step Up To Quality, accreditation or affiliation, licensing inspections and substantiated compliants. We offer this service by phone, and in-person as well.
    • Step Up to Quality helps families choose child care programs that go beyond the minimum standards of licensing. Rated programs demonstrate higher levels of quality in a variety of ways. If you would like more information about the Step Up to Quality program, your CCRC Tuition Assistance Specialist can assist you.
    • You may also visit our website to learn more about the services available to you and much more: www.ccrcinc.com
By typing your name in the box below you are signing this agreement.

Tuition Assistance Program: Required attachments

  • Must supply either pay stubs for complete 4 weeks or a letter from an employer on letterhead including hours and rate of pay fassigned by your employer.
  • Provide a current school schedule to qualify and updates per semester
  • Retroactive scholarship payments can be made for 1 month only with approval
  • One request per family per year will be considered

Any questions should be addressed by your Tuition Assistance Specialist, 
Delisa Nelson at DNelson@ccrcinc.com or 440-242-0413 ext. *245.

Must supply either pay stubs for complete 2 months or a letter from an employer on letterhead including hours worked and rate of pay for the 2 months.
No file selected
Provide a current school schedule to qualify and updates per semester
No file selected

Our Impact This Year

  • SUTQ Rated

    94%

  • CACFP Members

    147

  • Highly Rated

    58%

  • Training Hours

    358

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