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Child Care Coordination Office

iccp@cityofirvine.org

14341 Yale Ave. Irvine, CA 92604

949-724-6632

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Scholarship Application

Prior to submitting your application, contact the ICCP Program at your child’s elementary school campus to inquire about enrollment availability and rates.

INSTRUCTIONS:

  1. Please fill out the Irvine Child Care Project (ICCP) Scholarship Application form completely and submit no more than 30 days prior to your planned start date.

    • Information provided to the City through this form will be uploaded securely and used only for the purposes of determining scholarship eligibility, as outlined below.

    • One complete, submitted application is required for each child you are seeking tuition assistance (scholarship) for.

    • Incoming Transitional Kindergarten students are eligible to be funded beginning the first day they begin attending elementary school (ICCP Scholarship cannot be utilized to fund child care the summer prior to entering Transitional Kindergarten.  Submit your application no more than 30 days prior to the first date of the upcoming school year).

    • On the third screen of the online application in the section titled “Household Composition and Income” enter the names of all household members, including the child you indicated you were applying for tuition assistance for and the applicant’s name entered on the first screen.

  2. The following documents must be uploaded at the end of the completed application in order for your application to be considered. Please ensure you have a PDF copy of each required document ready to upload before beginning your application:

    • A copy of your entire federal tax return for the most recent tax year (must include a signature.) Only those children listed as dependents on the tax return are eligible for scholarship funds.

    • A copy of the W-2 form for each working adult listed on the tax return. If self-employed, please provide 1099 or Schedule C.

    • Copy of driver’s license or utility bill for proof of residency.  ICCP will accept any document on the Irvine Unified School District’s acceptable proof of residency documents as an alternative.  One document is needed for proof of residency for this scholarship application.

    • Copies of the three most recent employment check stubs, fewer than 30 days old and for each working adult listed on the tax return; copies of the four most recent employment stubs, fewer than 30 days old for each working adult listed on the tax return if paid weekly.

    • A copy of proof of any other income/support received. Please provide most recent award letter indicating monthly disbursement for any of the following: child support, alimony, cash assistance, Social Security, disability, food assistance, child care assistance, etc. Medi-Cal is not applicable.

    • If you are unemployed due to the coronavirus pandemic, please provide the most recent unemployment benefit letter indicating your weekly unemployment benefits.

    • Note: Further information/documentation may be required to complete your application. Without all required documentation, your application may be denied.

  3. Please allow a minimum of 15 business days from the submittal of a complete application to determine eligibility.  A complete application includes all required supporting documentation.  If additional documents or information are needed after initial review of your application that will add time to processing.  All communication regarding this scholarship application, eligibility and awards will be sent to the email address listed on the application. 

  4. If approved: 

    • Only those children listed as dependents on the tax return are eligible for scholarship funds.

    • Families must enroll in the designated ICCP child care program within 30 days of the scholarship offer; otherwise funds will be released for other families and the recipient must reapply for funding.

    • Scholarships are awarded for the current fiscal year ending June 30. Families must complete a new application form with all supporting documentation each fiscal year (July 1-June 30) to be considered for continued funding.

  5. Any tuition due for attendance to an ICCP program prior to scholarship activation date will not be paid for with scholarship funds. 

  6. Upon scholarship approval, applicant must complete an orientation within 30 days of approval letter date. Orientation must be completed prior to scholarship award funding. If orientation is not completed, scholarship approval is voided and applicants must reapply.

ADDITIONAL INFORMATION:

Scholarship funding is provided by the Irvine Children's Fund, a local nonprofit community support organization whose mission is to raise funds to increase access to quality child care for income eligible working families in Irvine.

No fax or email applications will be accepted. For questions, please call 949-724-6632.

Click the "Next" button to acknowledge and continue.

Irvine Child Care Project (ICCP)/Community Development Block Grant (CDBG) Public Service Intake

Reminder: Applications received more than 30 days prior to planned start date will be disqualified.  A new application will need to be submitted no more than 30 days prior to start date.

Desired start date at the child care program selected above:

I have contacted the ICCP child care program selected above in inquire about enrollment availability and rates

Reminder: You must contact the selected ICCP child care program directly to inquire about enrollment availability and rates.

Please note: Families must enroll in the designated ICCP child care program within 30 days of the scholarship offer; otherwise funds will be released for other families and the recipient must reapply for funding, so it is important to ensure the program has a space available for your child prior to applying for the scholarship.

Choose your start date for the program selected above:

Date Picker

Have you received an ICCP Scholarship in the past?

If yes, indicate date awarded:

Date Picker

This program is funded by a federal grant and we are required to collect certain information for reporting purposes. This information is confidential and will be used to compile statistical data only. 
 

Please complete the following information:

How did you hear about the ICCP Scholarship Program?:

FOR Families provides free information and short-term support to individuals, couples, and families living in Irvine who need assistance identifying and accessing needed services and resources. FOR Families services include consultations to help identify your needs, resource referrals to organization and programs best suited to assist you, and customized action plans to help individuals as they move forward. To learn more, obtain contact information to make an appointment, or to access a variety of online resources, please click here.

 

In addition, the City provides information and resources about the following topics online:

Resources for Parenting During COVID-19

Affordable Housing

Disability Services

Health Insurance Enrollment Assistance

LGBTQ+ Resources

Child Care and Development Information

Training Calendar for Parent and Caregiver Events

Click the "Next" button to acknowledge and continue.

Household Composition and Income

Enter required information for all household members, including all children. Income documentation or declaration of no-income is required for all family members in the household over the age of 18. For family members under the age of 18 that do not work, select "student" and an annual income of "$0."

Head of Household Gender:

Is the Head of Household Disabled?

Are you now, or have you ever, served in the United States Military:

Are you (check all that apply):

If currently unemployed, what was the last date of employment:

Date Picker

Is Household Member 2 Disabled?

Have they now, or have they ever, served in the United States Military:

Are you (check all that apply):

If currently unemployed, what was the last date of employment:

Date Picker

Do you have a third household member?

Is Household Member 3 Disabled?

Have they now, or have they ever, served in the United States Military:

Are you (check all that apply):

If currently unemployed, what was the last date of employment:

Date Picker

Do you have a fourth family member?

Is Household Member 4 Disabled?

Have they now, or have they ever, served in the United States Military:

Are you (check all that apply):

If currently unemployed, what was the last date of employment:

Date Picker

Do you have a fifth household member?

Is Household Member 5 Disabled?

Have they now, or have they ever, served in the United States Military:

Are you (check all that apply):

If currently unemployed, what was the last date of employment:

Date Picker

Do you have a sixth household member?

Is Household Member 6 Disabled?

Have they now, or have they ever, served in the United States Military:

Are you (check all that apply):

If currently unemployed, what was the last date of employment:

Date Picker

Do you have a seventh household member?

Is Household Member 7 Disabled?

Have they now, or have they ever, served in the United States Military:

Are you (check all that apply):

If currently unemployed, what was the last date of employment:

Date Picker

Do you have a eighth household member?

Is Household Member 8 Disabled?

Have they now, or have they ever, served in the United States Military:

Are you (check all that apply):

If currently unemployed, what was the last date of employment:

Date Picker

Do you have a ninth household member?

Is Household Member 9 Disabled?

Have they now, or have they ever, served in the United States Military:

Are you (check all that apply):

If currently unemployed, what was the last date of employment:

Date Picker

Do you have a tenth household member?

Is Household Member 10 Disabled?

Have they now, or have they ever, served in the United States Military:

Are you (check all that apply):

If currently unemployed, what was the last date of employment:

Date Picker

Household Gross Monthly Income

List the Household Gross Monthly Income (in dollars) next to each Source of Income Do not leave any box blank. If you do not have income from that source, enter "0" in the box provided.

Source of Income: Salary

Source of Income: SSI/SSD (Supplemental Security Income/Disability)

Source of Income: General Relief

Source of Income: Pension

Source of Income: Alimony

Source of Income: Child Support

Source of Income: Unemployment Insurance

Source of Income: Interest from Bank Accounts and Cash Funds

Source of Income: Rental Property Income

Source of Income: Other Income (not shown above)


Duplication of Benefits Certification

I certify that I have not received nor will accept other federal, state, local, or private assistance that duplicates the assistance provided under this Program.

Yes No

I certify that if I receive duplicative assistance, I will notify the Irvine Child Care Project within seven (7) days.

Yes No

Eligibility

In order to be eligible for the ICCP Scholarship, all adult household members must be employed. Due to the availability of temporary, one-time funds provided through the CARES Act, families who have lost employment, wages, or are at risk of homelessness due to the coronavirus pandemic may be eligible for funding.

COVID-19 Impact Certification

If you or members of your household have been financially impacted by the coronavirus pandemic, please indicate below. Check all that apply:

I lost income as a result of COVID-19:

Due to (please check all that apply):

Another adult member of my household lost income as a result of COVID-19

Due to (please check all that apply):

We are at risk of homelessness as a result of COVID-19.

Click the "Next" button to upload documents.

Upload Your Documents

The following documents are used to verify income in relation to scholarship eligibility. Please upload any and/or all of the following for further scholarship evaluation. After submission, you may be asked for additional documentation to verify eligibility.

A copy of your entire federal tax return for the most recent tax year (must include a signature). Only those children listed as dependents on the tax return are eligible for scholarship funds.

A copy of the W-2 form for each working adult listed on the tax return. If self-employed, please provide 1099 or Schedule C.

Proof of Irvine residency (copy of driver's license or utility bill). Please see Irvine Unified School District's list of acceptable proof of residency documents for alternative options.

Copies of the three most recent employment check stubs, fewer than 30 days old and for each working adult listed on the tax return; copies of the four most recent employment stubs, fewer than 60 days old for each working adult listed on the tax return if paid weekly.

A copy of proof of any other income/support received. Please provide most recent award letter indicating monthly disbursement for any of the following: child support, alimony, cash assistance, Social Security, disability, food assistance, child care assistance, etc. Medi-Cal is not applicable.

If you are unemployed due to the coronavirus pandemic, please provide the most recent unemployment insurance benefit letter indicating your weekly unemployment benefits or a print out of the payment details from the most recent payment issued, and the print-out of your California Employment Development Division Payment History.

Note: Further information may be required to complete your application. Without the above information, your application may be denied. 

According to Title 18, Section 1001 of the U.S. Code, it is a felony for any person to knowingly and willingly make false or fraudulent statements to any department of the United States Government.  I, the undersigned hereby certify that all statements contained herein, are true and correct to the best of my knowledge and belief.  I understand the information I provide in this certification is subject to verification, and I agree to provide necessary documentation if requested to do so.

Under the penalty of perjury, I certify that the above information is true and correct.

Digital Signature: Please enter your name, email address and sign the document.

Choose how to sign

The City of Irvine takes your privacy seriously. This form asks you to provide the City with certain personal information. Such information is being requested and will be utilized by the City for the specific and limited purpose of future City correspondence regarding the subject matter of this form. Pursuant to Measure S, an initiative ordinance passed by City voters in 2008, the personal information noted by an asterisk (*) on this form will be kept confidential. Unless you expressly indicate to us otherwise or unless compelled by a court order, it will not be shared with other agencies, business, or individuals.