Two ways to apply for CHIP using the downloadable application form
MS Word version of CHIP application
The Word version of the CHIP application is set up as a form which can be completed electronically. Pressing the tab key will move you from field to field. Once the application is completed, print the application, sign it and mail or fax it to the address/fax number on the application.
If you have MS Word installed on your computer, you can save and print the CHIP application form by:
Right clicking on the link below and select "save target as." Choose the location where you would like to save the application file and select "save."
PDF version of CHIP application
When opening the PDF application form, you may get a message telling you to upgrade the Adobe Acrobat software. Disregard this message. Just click on OK or hit the enter key.
IMPORTANT NOTICE: The information entered into the PDF file cannot be saved. Upon completion, the form must be printed out, signed, and mailed to the address on the application. If you have the application partially completed, print it out to "save" what you have entered. Fill in any additional information by hand, if necessary. If you close the PDF file and don't print out what you have entered, your information will be lost.
When filling out the application on your computer, you can use the following tools.
The following tools only work when the cursor is not in a field.