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Home
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Academic Support
Tutoring Center
Proctoring Services
Smarthinking
Student Success Center
Advising Checklist
Moodle Login and Important Contacts
College Catalog & Student Handbook
Commencement Information
Exit Counseling
Financial Aid
Credit / Clock Hour Conversion Programs
Conversion Charts
Disbursements
Financial Aid Forms
Federal Work-Study Program
Exit Counseling
How Financial Aid is Awarded
Financial Literacy
Net Price Calculator
Other Financial Aid Resources
Return of Federal Student Aid
Satisfactory Academic Progress
Scholarships
Types of Financial Aid
Find Classes
Publications
CareerFocus Magazine
Student Clubs and Organizations
High Altitude Balloon Team
Phi Theta Kappa
SGA
Student Handbook
Student Support
ADA / Disability Services
Career Closet
Career Development
Childcare Financial Assistance
Childcare Vendors
Daycare Information and Agreement
Monthly Child Attendance Verification
COMMUT-EDGE
Disability Services
Quality Enhancement Plan
Single Stop
START@ECC
Student Bicycle Program
Student Handbook
Student Services Contacts
Student Veterans
Student Veterans Association
Enrollment Pathway
Links
Forms
FAQ
Tuition and Fees
Daycare Information and Agreement
This form provides ECC with important information about the daycare and student-parent/child(ren) who are being served through the childcare grant program.
Facility Name
*
Facility director(s) or representative(s) who will complete monthly attendance verification and points of contact.
*
Facility Phone Number
*
Email Address
*
Mailing Address
*
Street Address
Address Line 2
City
ZIP / Postal Code
Physical Address
If different from mailing address
Street Address
Address Line 2
City
ZIP / Postal Code
Copy of NC State License or Religious Exemption Letter
Drop files here or
Accepted file types: pdf.
Completed W-9 Form
Drop files here or
Accepted file types: pdf.
Name of Student-Parent
*
Name(s) of Child(ren)
*
Current childcare rate for child(ren)
*
Childcare rate billed
*
Weekly
Monthly
Agreement
I have read and understand all of the information provided on the homepage for the childcare program. I agree to the terms of the program and will complete all necessary paperwork by the 5th of each month by 12 p.m. in order to receive timely payment.
I have completed all of the above information to the best of my knowledge and will provide updated information as needed, in a timely manner.
Name
This field is for validation purposes and should be left unchanged.
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