ECE Waived Tuition Application - Grant Parish Public Schools

2026-2027 ECE Waived Tuition Application

Grant Early Childhood Network — used to determine eligibility for publicly funded Early Childhood Care and Education (ECE) services.

Step 1 of 5 – Student Information

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This form is used to determine eligibility for publicly funded Early Childhood Care and Education (ECE) services. Please complete all sections and provide required documentation. Incomplete forms may delay eligibility determination.

Section 1: Student Information

Student's Name(Required)

First Middle Last Suffix

Gender(Required)

Male

Female

Collected for reporting only. Not used for selection.

Birth Date(Required)

Physical Address(Required)

Street Address Address Line 2 City State ZIP Code

Primary Phone(Required)

Secondary Phone

Email Address(Required)

Mailing Address

Mailing address is same as Physical Address

Mailing address is different from Physical Address

Mailing Address(Required)

Street Address Address Line 2 City State ZIP Code

Ethnicity & Race

Ethnicity/race information is collected for reporting only and is not used for selection.

Is the student Hispanic/Latino?

Yes, Hispanic / Latino

No, not Hispanic / Latino

Hispanic/Latino: a person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.

Student's Race (choose one or more)

American Indian or Alaska Native

Asian

Black or African American

Native Hawaiian or Other Pacific Islander

White

Section 2: Residency Verification

Please provide two (2) current documents. One must be a driver’s license showing the physical address.

Residency documents you are providing

Utility Bill

Lease Agreement

Mortgage Statement

Driver’s License

Other

Section 3: Parent/Guardian Verification

With whom does the child reside?(Required)

Mother

Father

Both Parents

Guardian

Name of person(s) child resides with(Required)

First Name

Last Name

Relationship to the Child

Section 4: Household Composition Verification

How many adults are in your household?(Required)

Adults in household (age 18 and over)(Required)

Adult's Full Name

Relationship to the Child

Date of Birth

Is any adult or the Head of Household disabled?

Yes

If yes, name of the disabled adult

Attach verification of disability (doctor’s statement or proof of disability, e.g., benefit award).

How many children are in your household?(Required)

Children in household (under 18 years of age)(Required)

Child's Full Name

Date of Birth / Age

School or Childcare Program (if attends)

Do you currently have a child in childcare?

Yes

If yes, what center do they attend?

Are you currently a recipient of, or on a waitlist for, any of the following?

Currently on CCAP

Currently on ECE Tuition Waiver in another network

Are any household members a foster parent or a foster child?

Yes

If yes, list their name(s)

Place of Birth (Birth Country)

Section 5: Employment / Education / Training Status

Parent/Guardian #1

Parent/Guardian #1 Name(Required)

First Last

Parent/Guardian #1 — Employer / School / Program Name

Parent/Guardian #1 — Hours Per Week

Parent/Guardian #1 — Gross Monthly Income

Parent/Guardian #1 — Current Status

Employed

Self-Employed

Full-Time Student

Part-Time Student

Job Training Program

Seeking Employment

Homeless

Other

Parent/Guardian #1 — Other status (specify)

Parent/Guardian #2 (if applicable)

Parent/Guardian #2 Name

First Last

Parent/Guardian #2 — Employer / School / Program Name

Parent/Guardian #2 — Hours Per Week

Parent/Guardian #2 — Gross Monthly Income

Parent/Guardian #2 — Current Status

Employed

Self-Employed

Full-Time Student

Part-Time Student

Job Training Program

Seeking Employment

Homeless

Other

Parent/Guardian #2 — Other status (specify)

Other Types of Income

Check every source of income that you or any household member receives or has applied for, and send proof of any income listed. Sources to consider: Child Support, Alimony, Unemployment Benefits, SSI / Supplemental Social Security, Social Security Benefits, Veteran’s Benefits, Retirement Benefits, Other Disability, Adoption Subsidy, Worker’s Compensation.

Does anyone in the household receive, or have they applied for, any of the income types listed above?(Required)

Yes

Income details

Source of Income

Receives? (Yes/No)

Applied For? (Yes/No)

Person Who Applies/Receives

Amount Received

How Often (Weekly/Monthly)

Add one row per income source that applies. Enter the date received/applied in the amount or person column if needed.

Persons in School or Training

Person in Training

Name/Address of School

Credit Hours in Class Each Week

Full Time or Part Time

Anticipated Completion Date

Persons Looking for Employment

Enter each person age 18 and over listed in Household Composition who needs child care assistance to look for work.

Persons Looking for Employment

Full Name

Parent Certification

I certify that the information provided on this form is true and complete to the best of my knowledge. I understand that providing false information may result in loss of eligibility for publicly funded ECE services.

Certification(Required)

I certify that the information provided is true and complete to the best of my knowledge.

Parent/Guardian Signature(Required)

Date(Required)

2026-2027 ECE Waived Tuition Application

Section 1: Student Information

Ethnicity & Race

Section 2: Residency Verification

Section 3: Parent/Guardian Verification

Section 4: Household Composition Verification

Section 5: Employment / Education / Training Status

Parent/Guardian #1

Parent/Guardian #2 (if applicable)

Other Types of Income

Persons in School or Training

Persons Looking for Employment

Parent Certification

Report Fraud or Waste

Report Child Abuse or Neglect

Quick Access

Families & Community

Transparency & Records

Staff & District