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Early Learning Resource Center Region 5
Families
Afford Child Care
Become a Relative Provider
Find & Choose Child Care
Resources for Families
Providers
Early Learning Programs
Child Care Works (CCW)
Professional Growth Opportunities
Rapid Response Team
Resources for Providers
News & Events
News
Events
About
Mission & Values
Partners
Staff
Careers
Locations
Early Learning Resource Center Region 5
Families
Afford Child Care
Become a Relative Provider
Find & Choose Child Care
Resources for Families
Providers
Early Learning Programs
Child Care Works (CCW)
Professional Growth Opportunities
Rapid Response Team
Resources for Providers
News & Events
News
Events
About
Mission & Values
Partners
Staff
Careers
Locations
Folder: Families
Back
Afford Child Care
Become a Relative Provider
Find & Choose Child Care
Resources for Families
Folder: Providers
Back
Early Learning Programs
Child Care Works (CCW)
Professional Growth Opportunities
Rapid Response Team
Resources for Providers
Folder: News & Events
Back
News
Events
Folder: About
Back
Mission & Values
Partners
Staff
Careers
Locations

Personal Interview Forms

ELRC Region 5 is providing fillable PDF forms for families. The PDF forms below can be downloaded, filled out digitally, and sent back to the ELRC Region 5.

NOTE: You must download the form prior to filling it out.

For additional questions, please contact ELRC Region 5 at 412.350.3577 or email us at elrc5@alleghenycounty.us.


  • Personal Interview Checklist

  • Personal Interview Packet

  • Former TANF Personal Interview Checklist

  • TANF Personal Interview Checklist

  • Consumer Statement

  • Rights and Responsibilities Form- Low-Income/Head-Start/Former TANF

    • Español

  • Authorization for Release of Information 

    • Español

  • HIPPA Notice Signature Page

  • Parent/Caretaker and Related Provider Attestation

  • Current Provider Information

  • A Parent's Handbook to Subsidized Child Care

  • How to Find, Choose, and Pay For High-Quality Child Care: A Guide for Families (PDF)

  • CCW Guidelines

  • Child Care Declaration Form

Find Resources Near You

The Allegheny County Family Resource Map provides caregivers of young children the opportunity to locate available supports closest to them, including food, housing, new parent, and employment resources.

Browse the resource map →

Search the ELRC Region 5 website

Locations

Main Office

304 Wood Street, Suite 400
Pittsburgh, PA 15222-1928

Monday–Friday:
8:00 a.m.–5:00 p.m.

Visit the Locations page for other locations and their hours.

Contact

Toll-Free Phone 1-888-340-3572
Phone 412-350-3577
Fax 412-350-3575

elrc5@alleghenycounty.us

Contact

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