STOP!!! DO NOT BEGIN YOUR APPLICATION UNTIL YOU HAVE COLLECTED ALL REQUIRED DOCUMENTS. ONCE YOU SUBMIT YOUR APPLICATION YOU CANNOT RETURN TO IT TO CHANGE IT OR ADD DOCUMENTS. A complete list of all required documents may be found on our website. Applications will not be considered until all documents are received.
Please complete the following section about yourself, the primary adult.
Click here to find a provider in your area.
Please answer the questions in the section below about the other adult/parent. The question "Lives with Family" means this person lives in the household with the child and the primary adult.

Are there other adults in the household?

Add Another Adult
Use your income documents to determine your gross annual income, before taxes or other deductions. Be sure to include income from all adults that live with you and contribute to the total household income. If you are living with someone else, and they are not financially supporting you, you do not need to include them or their income on your application.
Please answer the questions below about your child.
- Your Address - Available Locations
Click a location on the map to see more info
Click here to find a provider in your area.

Do you want to apply now for another child in your family?

Add Another Applicant

Are there other children in the family?

Add a Sibling
Thank you for your application. Please ensure you have submitted all required documents. Documents may be uploaded to your application or dropped off at our office located at 521 N. Burnside Avenue, Gonzales, LA 70737
Required information is missing, see above.