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Contact Us

Contact us

Beaumont Location
510 Park Street, Suite 215
Beaumont, Texas 77701
Phone: 409-839-8045
Fax: 409-838-4048

Port Arthur Location
4680 FM 365
Port Arthur, Texas 77642
Phone: 409-962-1236

Please use the Change to members in the household box to indicate your changes for school transfers or transportation.


If you receive child care assistance, or on the waiting list and you have a change to report, please fill out the form below:

First Name:*
Last Name:*
Last 4 digit of Social Security #:
Spouse Name ( if applicable):
Contact Number:*
E-mail Address:
Date of Birth:* (mm/dd/yyyy)
Requested Change: please check the appropriate box or boxes below
Address:   City:  
State:   Zip Code:  
Home Number:  
Cellular Phone:  
E-Mail Address:  
  1. Child care authorizations typically begin at the beginning of each month. If your situation is an emergency, please contact our office at 409-839-8045
  2. You must visit & complete all of the child care forms before it can be approved
Note: Please do not start child care at the new facility until you have heard from CCCS. We must authorize child care at the new facility.
Effective Date: (mm/dd/yyyy)
List Additional Income
(if applicable)
Start Date: (mm/dd/yyyy)
Last Day at Previous Employer/Training: (mm/dd/yyyy)
Name of Employer:
Date: (mm/dd/yyyy)
Start Date: (mm/dd/yyyy)
Days in Week:
Work Hours:(hh:mm) to
Reason for the reduction:  
Note: Backup documents may be required to verify your need for assistance.