ChildCareGroup | Child Care Assistance


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Attendance Card Management

Personal Information

First Name:
Last Name:
Last 4 digit of Social Security #:
Contact Number:	(xxx-xxx-xxxx)
E-mail Address:
Date of Birth:	(mm/dd/yyyy)

Request for attendance card

Add new card holder(s). Parent can designate up to 3 additional card holders for the family. Note: All card holders must be at least 18 years of age unless they are the parent of the children in care, and the child care provider may NOT be a card holder.
Card Holder 1:
First Name:
Last Name:
Date of Birth:	(mm/dd/yyyy)
Card Holder 2:
First Name:
Last Name:
Date of Birth:	(mm/dd/yyyy)
Card Holder 3:
First Name:
Last Name
Date of Birth:	(mm/dd/yyyy)
Delete current card holder(s)
Card Holder 1:
First Name:
Last Name:
Card Holder 2:
First Name:
Last Name
Card Holder 3:
First Name:
Last Name:
Re-issue card for:
Myself
Other card holder	Name
Other card holder	Name
Other card holder	Name
Note: all cards will be mailed to the parent’s address as listed in our system.
Report problem with using the card