Child Care Application Check Sheet
In order to process your application and determine eligibility, we will need the following information completed in Blue or Black ink only. Colored ink, pencils, and/or white-out may not be used.

Click on the document name to access the document:

If you and/or your spouse/second parent are working (one for each job) we need:

• Employment Verification Form (Form # CS0004) – this form must be completed by your employer for everyone who is employed in your household. Please print as many as you need.
• Last 3 Months of Check Stubs – must be provided for each person working
• Employment Verification Form **ONLY IF NEW JOB**
• Self- Employment Form or most recent tax return (only if Self- Employed) – form must be completed and all required documentation must be included with form.

If you and/or your spouse/second parent are in school or training (one for each school/training program):

• Class Schedule- must be provided for your training and your spouse/second parents training for the current semester.
• Transcripts (Official or Unofficial) from School/Training – must be provided if this is not your first semester. If you are married or have a second parent in your household, you will need to submit their official/unofficial transcript.
• Training Verification Form – form must be completed by your high school or GED institution. If you are married or have a second parent in your household, you will need to submit this form for both you and the second parent.

All households must provide the following:

• Citizenship and Age verification documents
• Other income (ex. SSDI, Workers Compensation)

If you have any questions, please contact us by email at ccs@netxworks.org or telephone: 903-794-8999 or 1-800-874-3226.

The online application you submitted is active for 30 days. Please submit the required documents within the 30 day time frame.

If your online application exceeds 30 days, you will need to reapply.

Please FAX all documents to: (903)-794-8012
Please EMAIL all documents to: ccs@netxworks.org
Please MAIL all documents to: Workforce Solutions Northeast Texas Child Care Services 1702 Hampton Rd. Texarkana, TX. 75503
Please DROP-OFF documents at our Texarkana location: The Greater Texarkana Workforce Center Child Care Services 1702 Hampton Rd. Texarkana, TX. 75503