NYC Facilitated Childcare Enrollment Project Eligibility Request

Have a child? We May Be Able To Help through the Child Care Facilitated Enrollment Project.

Childcare Assistance Request


Please complete the following form to verify your eligibility for the NYC Facilitated Childcare Enrollment Project. Upon submission, a Local 338 staff member will be contact you about your eligibility and next steps.
Applicant's Name/ Nombre del solicitante: 
My Member Identification number (RWD#): RWD
My Social Security Number is:
Email Address: 
Street Address/ Dirección de domicilio:
Apartment #: 
City:   State:    Zip Code:
Home Phone / Teléfono de domicilio:
Cell Phone / Teléfono móvil:


Please supply the appropriate information / Por favor suministrar la siguiente información:

1. Do you live in the Bronx, Brooklyn, Manhattan, Queens or Staten Island?
YES   NO

2. Do you have children under the age of 13?
YES   NO

3. How many children do you have under the age of 18?


4. Do you work at least 20 hours per week?
YES   NO

5. Does your children’s other parent live in the same household as you?
YES   NO

6. If you answered “Yes” to #5, does your children’s other parent work more than 20 hours a week?
YES   NO

7. Are you already receiving an ACS childcare voucher for any of your children?
YES   NO

8. What is your annual household income?
$

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LOCAL 338 RWDSU/UFCW  •  1505 Kellum Place  •  Mineola, New York 11501
Main Office (516) 294-1338  •  Union Call Center (516) 294-1338 ext. 1775  •  Medical Call Center (516) 294-1338 ext. 1776
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