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Form Details & Downloads

Child Care Assistance application Download Form

This is the application for families seeking child care assistance.
Print out this form, complete the application and return it to:

Athens County Job & Family Services
Child Care Unit
184 N. Lancaster St.
Athens, OH 45701

For questions or assistance with the application, call our child care unit at:
(740) 797-2523 or 800-762-3775.

Application for Child Care Provider Certification Download Form

This is the application for individuals interested in becoming a certified provider of child care.
Print out this form, complete the application and return it to:

Athens County Job & Family Services
Child Care Unit
184 N. Lancaster St.
Athens, OH 45701

For questions or assistance with the application, call our child care unit at:
(740) 797-2523 or 800-762-3775.

Application / Reapplication Verification Request Download Form

To determine eligibility for public assistance, it is necessary to provide proof of your statements on the application form. This form lists the documents most generally required to verify certain eligibility factors. We will assist you in obtaining any need verification you are unable to obtain yourself.

Right & Responsibilities Download Form

This document explains your rights & responsibilities as an applicant or program participant of our programs.  Athens County Department of Job & Family Services is an equal opportunity employer & service provider.

Healthy Start/Healthy Families Medical Coverage Download Form

Healthy Start/Healthy Families provides free health care coverage to families, children (up to age 19) and pregnant women through the Medicaid program. 

Complete and return the application to any one of our offices or send it by mail to:
184 N. Lancaster Street, Athens, OH 45701.

For the Healthy Start/Healthy Families coverage ONLY, a face to face interview is NOT required. If you have questions or need help to fill out the application, call our help desk at:
1-800-762-3775.

NOTE: Families interested in getting cash assistance through Ohio Works First, Food Stamps, or Medicaid for the aged, blind or disabled should complete the combined application for Food Stamps, Cash and Medicaid (also available from our list of forms).

Job Application (to apply for agency positions) Download Form

The JOB APPLICATION form is the document that will be used to determine if you meet the minimum qualifications for an open position with the agency.  You must show clearly, by experience or training that you meet the minimum qualifications for a particular position.

Print out the application, complete it and with your resume and cover letter, submit it to:

Athens County JFS
184 N. Lancaster Street
Athens, OH 45701

Request for Cash, Food and Medical Assistance Download Form

This form allows you to apply for Food Assistance, Cash Assistance (Ohio Works First program) and Medicaid in one combined form.

Complete and return the application to any one of our offices or send it by mail to:

Athens County JFS
184 N. Lancaster Street
Athens, OH 45701

Once we receive the application, a face to face interview will be scheduled to complete the application process.   ***It is important that you mail, fax, or deliver your application to our agency as soon as possible as it could affect the first day that you may be eligible to receive benefits.

If you have questions or need help to fill out the application, call our help desk at:
(740) 797-2523 or toll-free 1-800-762-3775.

The Verification Request Download Form lists some items that you may need to bring to your interview. If you do not have all the documents that you need, the county caseworker will give you some more time to get those documents. If you need help getting the documents, ask your caseworker for help.

Your Rights & Responsibilities Download Form is a longer document that lists important information for you about what you will need to do if you are found eligible for cash, food stamps or medical benefits. Print this copy and read it. You will be asked to sign a copy at the end of your interview.

Application for Prevention, Retention and Contingency (PRC) program and Workforce Investment Act (WIA) program Download Form

This form allows you to apply for both the Prevention, Retention and Contingency (PRC) program and the Workforce Investment Act (WIA) program.