Little Suncats Program Application Please note: we require one application per child. Thank you. Semester Spring 2024 Student-Parent Information CNM ID Number First Name Last Name Date of Birth CNM Email Telephone Number Demographics Gender Female Male Ethnic Background American Indian or Alaska NativeAsianBlack or African AmericanHispanic or LatinoHawaiian or Other Pacific IslanderWhiteTwo or More Races Household Status MarriedNot Married and DependentNot Married and Independent Martial Status SingleDivorcedMarriedSeparatedWidowed Child Care Information Who currently pays for child care? Self-Paid CYFD Other If you selected "other" please specify. Child's First Name Child's Last Name Child's Date of Birth Select Child's Age InfantToddlerPreschoolSchool Age Child Care Provider Name Type of Care Needed Full-timePart-timeBefore/After CareDrop InAPS Breaks Monthly Payment/Co-Payment Top Three Preferences for Child Care/After School Placement Note: All child care providers must be approved by the program manager. 1. 2. 3. Household Information Does your child receive free or reduced lunch at school/child care? Yes No Are you currently employed? Employed full-time Employed part-time Not employed Do you receive funding from any of the following sources? Check all that apply. Not applicable TANF (Public Assistance) SNAP Child Care Assistance Social Security D.V.R. (Disability Vocational Rehab) W.O.I.A. (Workforce Investment Act) Other If you selected "other" please specify. How did you find out about the Little Suncats program? Another CNM Student Flyer/Poster on Campus CNM Website Facebook Instagram Twitter Faculty/Staff Member CNM Email Other If you selected "other" please specify. I certify that all the information provided on this form is correct and complete to the best of my knowledge. I give permission to the Little Suncats program to access myCNM educational records in reference to academic transcripts, degree plans, financial aid status/awards, and any other pertinent information related to my educational endeavors. Spam Check This program is 100% grant funded by the U.S. Department of Education.