2026 CCAMPIS Program Profile Form_Final Edit.docx

CHILD CARE ACCESS MEANS PARENTS IN SCHOOL

PROGRAM PROFILE FORM

Instructions: All applicants must complete this form and attach it to the Other Attachments Form in the application package in Grants.gov (as a PDF or Word document).

DO NOT MODIFY OR AMEND THE CONTENTS OF THIS FORM.

In the FY 2026 competition, the CCAMPIS grant program has two absolute priorities and one invitational priority.

Applicants who do not address both absolute priorities are subject to submission being disqualified. (All Priorities addressed should be no more than 3 pages in length)

Did you address?

Yes: ____ or No: ____ Absolute Priority 1: Leverage significant local or institutional resources, including in-kind contributions, to support the activities assisted under Section 419N of the Higher Education Act (HEA).

Yes: ____ or No: ____ Absolute Priority 2: Utilize a sliding fee scale for childcare services provided in order to support a high number of low-income parents pursuing postsecondary education at the institution.

Yes: ____ or No: ____ Invitational Priority 1: Expanding Education Choice in Early Learning Settings. Projects that are designed to expand access to education choice for parents with children in early learning settings, including by empowering parents in choosing the early learning setting that best meets their family’s needs, as well as by providing flexible childcare.

Please select (A) or (B) below that best describes your application and complete questions 1-10 as applicable:

A. ______ Are you an existing applicant? (The applicant currently has a childcare center on campus or currently provides CCAMPIS childcare services for the parent-students that attend your institution).

B. ______ Are you a new applicant? (The applicant does not have a childcare center that provides CCAMPIS childcare services for the parent-students that attend your institution).

1. Name of Applicant Institution/Campus, Institution/Campus OPE ID #: (Use your institution’s complete name. If your institution is a branch campus, use the parent institution’s name but follow with the name of the branch campus. For example, you would cite the State University of U.S.A., Happy Campus)

Name: __________________________________________

OPE ID #: ___________________________________

PR Award #: (if currently funded) ______________________ (if not currently funded insert: N/A

2. Applicant Address: (Indicate the address where the program will be located) Street: ____________________________________

3. The total amount of Federal Pell Grant funds awarded to students by the applicant institution for the preceding fiscal year, FY 2025 (Pell amount must be specific to the applicant institution and not an aggregate College/University District or System amount): $_________________________________________

4. Total amount listed from the ED Form 524 (Yr. 1 Only) $ ________________

5. Does the Applicant have Institution childcare center(s) and/or outsourced childcare center(s) that are nationally accredited?

If no, please check here: ___ If yes, please check here: ____ *Please enter information in chart below.

6. Does the applicant institution offer an early childhood education curriculum?

Yes: _____ No: _____

7. The intended types of childcare services to be provided (Please mark all appropriate):

Infant _____ Toddler ____ Before & After School Care____ Summer ____ Other ____

8. (Please mark all that apply): Licensed Childcare services be conducted by center(s),

9. Total number of parent-students your program plans to serve: ____

10. Total number of children your program intends to serve: ____