DHS Forms

At the end of the class, you will need to fill out these two forms and email them to hadiyah.miller@mhcc.edu. You may sign with a signature or by typing your name.

2018-19 License Exempt Family Child Care Provider Training Reimbursement English

Stipend Form

Substitute W-9 Form

2018-19 License Exempt Family Child Care Provider Training Reimbursement Spanish

W-9 Form

Stipend Form

License Exempt Family Child Care Provider Training Reimbursement English

Stipend Form

Substitute W-9 Form

License Exempt Family Child Care Provider Training Reimbursement Spanish

W-9 Form

Stipend Form

If you need assistance, please call Hadiyah Miller at 503-491-6222.

You will receive a phone call from our staff within a week of taking the class and completing the online form. You must speak to our staff over the phone to complete the orientation process. Failure to complete the process may lead to a FAILED provider status and loss of income.