Family Reduced Fee Application             2024-2025 
The Extended Day Care Program (EDCP) provides reduced fees to eligible families with a household income below $122,000. To receive a reduction in fees you must submit the Family Reduced Fee Application. This form must be completed for the summer and school year programs, including all necessary verification, and be on file with the Extended Day Care Office to be considered for reduced fee eligibility. If any information provided is unclear or ambiguous, further verification may be required.  Fee reductions will take place at the next payment period after verification. Re-certification is done annually regardless of the start date, as changes occur throughout the year.

The Day Care Program works with the City of Falls Church Housing and Human Services Division to meet the financial needs of our families. Please contact the Housing and Human Services Division at 703-248-5005 for information about other services available to Falls Church City residents.

Income includes:

Salary

Other Income - Child support, alimony, disability, income from other household members, veteran’s benefits, TANF/VIEW assistance, unemployment benefits, social security benefits.

Military Personnel - in addition to basic pay, special allowances such as BAH, BAS, and CMA are considered earned income.

Self-employed, no pay stubs - If you are self- employed or do not receive pay stubs from your employer, the following documentation is required:

Self-Employed – a copy of the most recent tax return, if self-employed less than 12 months, complete Self Employed Information Form.
No pay stubs? A letter from employer stating hourly, monthly or annual salary and number of hours per week.

No-Income Status 
Undergraduate School or Job Training – documentation verifying enrollment and payment of tuition must be emailed to clintonk@fccps.org.

Disabled – verification of a disability from medical professionals emailed to clintonk@fccps.org.

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Email *
Name of parent/guardian completing this form: *
Today's date: *
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Names of children enrolled in EDCP: *
Names and relationships of ALL household/family members, ages of all children in the household/family: *
Sources of income: choose all that apply *
Required
Verification of all income is required when applying for Reduced Fees. Email the two most recent pay stubs for all adults in the household who are responsible for the care and safety of children, as well as any additional income verification from the options above, to clintonk@fccps.org.  *
Required

I hereby affirm that the information provided is true and accurate to the best of my knowledge and belief.  I understand that giving any erroneous or inaccurate information may prohibit me from qualifying for a reduction in my child care fees and could result in loss of day care services. I will notify the Extended Day Care Office within 10 days if any information changes. The Day Care office may seek additional verification if they believe my circumstances have changed. I understand that any fee reduction resulting from changes in the household income information will become effective at the next payment period after verification of income. I also understand that not reporting new income or change of status within 10 days could result in loss of day care services or payment of back fees resulting from the change. An incomplete form will be returned to me.  I also understand that I am not eligible for a reduction in fees until my income has been verified and is on file with the Extended Day Care Office.


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