Foothill Learning Center Child Care and Development Financial Assistance Program Qualify for Child Care financial assistance? Calificar para asistencia financiera de cuidado infantil? Name / Nombre * First Name Last Name Phone / Telefono (###) ### #### Email / Correo Electronico * Are children receiving Child Protective Services? / ¿Los niños reciben servicios de protección infantil? Yes No Is family receiving CalWORKs cash aid?/ ¿Recibe la familia asistencia monetaria de CalWORKs? Yes No Is family receiving Child Care and Development Services for Children with Special Needs (CHAN)? / ¿Recibe la familia Servicios de Cuidado y Desarrollo Infantil para Niños con Necesidades Especiales (CHAN)? Yes No Is family enrolled in the Federal Based Migrant Program? / ¿La familia está inscrita en el Programa Federal de Migrantes? Yes No Have children in your family been identified as at risk of abuse or neglect? / ¿Se han identificado niños en su familia en riesgo de abuso o negligencia? Yes No Is family experiencing homelessness? / ¿La familia está sin hogar? Yes No Does family meet California State Income Ceiling? / ¿Cumple la familia el límite máximo de ingresos del estado de California? Yes No Please provide age of child in need of child care. / Por favor proporcione la edad del niño que necesita cuidado de niños. Is child currently enrolled at a CSPP, Headstart, etc? / ¿Está el niño inscrito actualmente en un CSPP, Headstart, etc? Thank you! We have received your Foothill Learning Center Child Care and Development financial assistance application. You may be contacted with a request for additional information.
