Child care providers may report changes in holidays, emergency closures and other changes using the form below.

Select County from the drop-down menu first to filter the list of providers. Contact information will be populated with data on file; make any changes to name, phone number or email address before submitting the form.

* indicates required fields

County*

Select county Collin Cooke Dallas Denton Ellis Erath Fannin Grayson Hamilton Henderson Hill Hood Hunt Johnson Kaufman Navarro Palo Pinto Parker Rockwall Somervell Tarrant Van Zandt Wise Wood Young

Provider Name* (CCS Provider Number)

Select provider name

Contact Person*
Daytime Phone*
Email Address*
Changes to be reported (check all that apply)
Add Provider Holidays	All licensed and registered providers with a CCS Agreement can be paid for up to nine (9) holidays per year.  All holidays must be requested at least two weeks prior to the holiday in order to receive payment. Holidays must be during normal business days. Date 1 Date 2 Date 3 Date 4 Date 5 Date 6 Date 7 Date 8 Date 9
Remove Provider Holidays	All licensed and registered providers with a CCS Agreement can request removal of holidays when the provider plans to remain open.  All removals must be requested at least two weeks prior to the holiday. Date 1 Date 2 Date 3 Date 4 Date 5 Date 6 Date 7 Date 8 Date 9
Emergency Closure	Date(s) of Closure Reason for Closure
Unpaid Provider Holidays	Additional days the provider plans to close that will not be paid by CCS. Date 1 Date 2 Date 3 Date 4 Date 5
Other Changes