(a) To apply for financial assistance, an applicant shall submit to the Department an application on the form that the Department requires.

(b) The application shall include:

(1) The identity and location of the family child care provider;

(2) An itemization of known and estimated costs;

(3) The total amount of funds required by the family child care provider to comply with State and local regulations;

(4) The funds available to the applicant without financial assistance from the Department;

(5) The amount of financial assistance sought from the Department;

(6) A statement from the family child care provider on how the grant funds will be used;

(7) Information that relates to the family income of the grant applicant; and

(8) Any other relevant information that the Department requests.