Contracted Slots Interest Form - Pennsylvania’s Contracted Slots Program

Sep 19, 2026

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Contracted Slots Interest Form for Pennsylvania’s Contracted Slots program, requesting parents or guardians to express interest in enrolling a child with a specific provider and location. The form explains that eligibility is determined by the Early Learning Resource Center (ELRC) after submission of a Pennsylvania Application for Subsidized Child Care with residency, employment, training, and income documentation. It also clarifies that completing the forms does not guarantee eligibility or enrollment, which depends on slot availability and provider priorities.

LanguageEnglish

CategoryForms

FormatPDF

Pages1

AccessFree to download

Program Interest Information

Parent/Guardian Child Enrollment Details

ELRC Eligibility and Application Submission Methods

Enrollment Intent and Signatures

FAQs

What information does the parent or guardian need to provide?

The form collects the parent or guardian name, the child’s name, and the selected provider name, location address, and contact details.

How does eligibility for Contracted Slots get determined?

ELRC determines eligibility after the parent submits a completed Pennsylvania Application for Subsidized Child Care with documentation of residency, employment, training programs, and income.

Does completing this interest form guarantee enrollment?

No. Completing the Contracted Slots Interest Form and the Pennsylvania Application does not guarantee eligibility or enrollment; enrollment depends on slot availability and the provider’s prioritized strategy.

Sep 19, 2026

Upload by Eden