(a) To apply for a direct incentive grant, an applicant shall submit to the Department an application on the form that the Department requires.
(b) The application shall include:
(1) The name and address of the child care provider;
(2) An itemization of known and estimated costs including a statement from the child care provider as to how the grant funds will be used;
(3) The total amount of funds required by the provider to purchase supplies, material, and equipment;
(4) The funds available to the applicant to purchase supplies, material, and equipment;
(5) The amount of direct incentive grant funds sought from the Department;
(6) The number of children that the child care provider serves who receive child care subsidies through the purchase of child care program; and
(7) Any other relevant information that the Department requests.