FY20 Faculty Child Care Assistance Program Application (Pro-Rated Schedule)

The Faculty Child Care Assistance Program (FCCAP) provides a salary supplement to eligible faculty to offset qualified child care expenses for children 5 years of age and younger. Full, assistant and associate professors in the tenure and non-tenure line, and Medical Center line, are eligible. Award levels are based on an applicant's household income and range from $6,000 to $24,000. The FCCAP awards are disbursed through a reimbursement process and are taxable income.

If granted, award will begin on the first of month after the application has been submitted and will be prorated for the remainder of the fiscal year. (Example: an application received and processed on January 1, 2020, will be a 7-month grant covering February 1, 2020 through August 31, 2020.)

* indicates required fields.

Application Period

Faculty *

Household Information

Household Status - Please Select One Option: *

Name of Spouse, Partner or Registered Domestic Partner *

Partner's Employment Status *

Financial Documentation

In order to determine a potential award, the following documentation is required with your application. Please follow the checklist below and check-off each item: *

The child (or children) listed above is (are) my current tax dependent(s). *

Do you currently receive child support per court order? *

Finalizing Your Application

Statement of Understanding: By submitting this form, I certify that I will send all applicable tax forms and other income source documents, including pay statements, using Stanford University's Secure Email protocol. I understand I must notify the WorkLife Office of any family status changes (i.e. dissolution of marriage or domestic partnership) which could affect my child custody responsibilities during the plan year I receive a Faculty Child Care Assistance Program award. I certify under penalty of perjury that all statements and documentation relating to this application are true. I understand that incomplete and or inaccurate information may adversely affect my child(ren)'s eligiblity under this Program up to and including repayment to Stanford University of any funds awarded and/or may result in disciplinary action up to and including termination. *