Programs & Applications
The Programs
The Benefits
The Requirements
The Application
The Forms & Worksheets
Self-Employed Information
Frequently Asked Questions
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Filling out the application online is quick and easy!
There are a few important things you need to know before you start. This process allows you to fill out the application online but it must be printed and mailed to us.
- You must have a printer to print the application once you fill it out.
- You cannot save your information. If you have to stop and exit the site, you will have to start over.
- If you have more than four children, you cannot fill out the application online. Please click here to download the application and fill it out by hand.
- It will be helpful for you to gather needed information and certain documents before starting the application. You should have:
- birth certificates
- social security numbers
- employment and income information
- current and past health insurance information
- You will need Acrobat Reader to view the final application. If you need to download this free software, please click the button below.
I'm ready to fill out this application
