Provider Document Submission

This document submission portal is used to submit necessary paperwork for your childcare case.

IMPORTANT INFORMATION:

Only PDF formatted documents will be accepted. No Exceptions!
Any pictures and screenshots of documents (JPG file) will not be accepted! No Exceptions!
If you are submitting documents for a parent, please click here for the parent document submission portal. A separate submission should be completed for each parent.
Childcare Certificates will not be accepted! No exceptions!

Please submit certificates via Mail, Fax or dropbox.

You can still submit documents via mail, fax or drop box

Please Visit our CCAP Express Page here.

If you need to submit forms for a parent, please submit here.

If you have any questions regarding your CCAP case, please email us at CCAPQuestions@actforchildren.org

Submission Date*

Provider Type*

Select

Provider First Name*

Provider Last Name*

Provider Business Name*

Phone Number*

Helpful Tip: Please add best phone number to reach customer, if needed.

Provider ID Number

Do not use Social Security Number or (-) between numbers

Example: 1234567898765

Provider's Date of Birth*

Parent Name (If Applicable)

IMPORTANT: If submitting documents for a childcare case, please add parent's full name here. This helps our team locate the parent's childcare case.

Parent's Date of Birth*

IMPORTANT: Please add parent's correct Date of Birth. This helps our team locate the parent's childcare case

Parent Childcare Case Number ( If Applicable)

If submitting documents for a childcare case, please add Case number here.

Form Submitted*

Please Read: Forms submitted through this portal should be Provider Forms only! Parent forms should be submitted through the Parent Document Portal!

Helpful Tip: Please write the Childcare Case Number on document before submitting. This ensures documents are placed with the appropriate case.

Select