Apply for TANF

Submission info & disclaimers

Form will be submitted to Amy Reyes, TANF grant administrator. Wyoming Department of Education. TANF money shall only be used for one (1) or more of the following:

Provide assistance to needy families so that children may be cared for in their own homes or in the homes of relatives.
End the dependence of needy parents on government benefits by promoting job preparation, work and marriage.
Prevent and reduce out-of-wedlock pregnancies; and establish annual numerical goals for preventing and reducing the incidence of these pregnancies.
Encourage the formation and maintenance of two parent families.

Contractor shall be specific on what TANF purpose their program/service is addressing.
Participants served shall be families with a child(ren) with income below 185% of the Federal Poverty Level (FPL).
Participants also shall meet citizenship/eligible immigrant and residency criteria to be served.
For questions contact Amy Reyes, amy.reyes@wyo.gov or 307-777-7708

Table 1: 185% FPL income guideline effective 4/2025

	185% FPL	185% FPL
Household Size	Potential TANF eligible Monthly Income	Potential TANF eligible Yearly Income
1	2,461	29,526
2	3,336	40,034
3	4,212	50,542
4	5,088	61,050
5	5,963	71,558
6	6,839	92,574
7	7,500	92,574

Eligibility Guidelines for TANF Money (Non-Assistance)

TANF money shall only be used for one (1) or more of the following:

Provide assistance to needy families so that children may be cared for in their own homes or in the homes of relatives;
End the dependence of needy parents on government benefits by promoting job preparation, work and marriage;
Prevent and reduce out-of-wedlock pregnancies; and establish annual numerical goals for preventing and reducing the incidence of these pregnancies; and
Encourage the formation and maintenance of two parent families.

Contractor shall be specific on what TANF purpose their program/service is addressing.
Participants served shall be families with a child(ren) with income below 185% of the Federal Poverty Level (FPL).
Participants also shall meet citizenship/eligible immigrant and residency criteria to be served.
Programs will be operated on a cost reimbursement basis.
Administrative costs are limited to 10% of the program cost. Program costs are costs associated with the delivery of the service.
Performance measures are required. The Contractor shall address how performance measures and data collection will occur to validate the program success.
Reporting is also required when utilizing TANF funds. The following reports shall be required:
Monthly/quarterly program performance reports will address program outcomes, successes, challenges and client tracking;
Monthly/quarterly fiscal reports;
List of clients served each month; and
Final summary report.
TANF funds shall not be used to provide individuals served by the projects with cash, cash cards or check(s) payable directly to the individual(s) or credit card company gift cards.

Select a Preschool

Parent & Student Information

Legal Guardian

How were you referred to TANF? I.e. Search engine, case worker, friend/relative, other.

Child/Student Information

First Name

Last Name

SSN

Date of Birth

Primary language spoken in home

Child Race/Ethnicity

Address

Qualifications

Is your family's current living situation due to a loss of housing or financial hardship?

Are there any siblings five years old or younger living in the household?

Are you or the children in your care currently lacking a fixed, regular, and adequate nighttime residence? Which includes one of the following:

Place not meant for human habitation.
Living in a shelter (Emergency shelter, hotel/motel paid by government or charitable organization)

Is your family on a plan of safe care?

How often are you paid?

How many adults are living in your home?

How many children are living in your home?

What is the total gross monthly income for all adults in your household?

Is this child covered under Kidcare chip?

Would you like to enroll to receive child health insurance services?

Would you like additional information about assistance in the community? food pantry, rental assistance, shelter etc....

Do you have paystubs to include?

Certification Statement

I certify that all of the above information is true and correct and that all income is reported. I understand that this information is being given for the receipt of federal funds; that agency officials may verify the information on the application; and that deliberate misrepresentation of the information may subject me to prosecution under applicable state and federal laws. The signature on this application is that of an adult household member. In place of a signature on the application you can upload a signed application below.

WINDS Forms