WSU SpokaneStudent AffairsAccess and WellnessChildcare Subsidy ProgramChildcare Subsidy Application

Childcare Subsidy Application

To apply for the Childcare Subsidy Program, complete the application below and upload a completed copy of the Childcare Provider Form (PDF). Note that the provider form requires details and a signature from your childcare provider in order to be considered complete. Questions can be directed to spok.accesswellness@wsu.edu.

Step 1 of 3

Name*
First Last
Student ID Number
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Phone*
WSU Email*
Please enter your WSU email
Student Type*
Program of Study*
Anticipated Graduation Date
MM slash DD slash YYYY

1st Child's Name*
First Last
Age
Name of Childcare Provider*
Phone Number of Childcare Provider*
2nd Child's Name
First Last
Age
Name of Childcare Provider
Phone Number of Childcare Provider
3rd Child's Name
First Last
Age
Name of Childcare Provider
Phone Number of Childcare Provider

Please explain why you are applying for the Childcare Subsidy.*
Date*
MM slash DD slash YYYY
Student Name*
First Last
By entering the date and my name, I confirm that this information is correct to the best of my knowledge. I authorize the release of information from any and all agencies.
Provider Form Upload*
Upload a signed copy of the Childcare Provider Form here.
Max. file size: 146 MB.

Take Action

Quick Links

Upcoming Events

Childcare Subsidy Application

Step 1 of 3