Apply for ECEAP | YWCA Spokane

Online Application

Please complete the below form if you would like your 3 or 4 year old to attend YWCA Spokane's early childhood education program. You may also drop off or mail the paper application if preferred.

Apply for Free Pre-School

Note: If you need assistance with filling the application out, please give us a call at 509-326-1190. You may also drop off or mail the paper application, if preferred, to YWCA Spokane, Attention: Free Pre-School, 930 N Monroe St, Spokane, WA 99201.

ECEAP Application

Online application form

If you would like help filling out this application, please contact a Family Service Advocate!

Downtown: 509-507-0261, 509-863-2257 Airway Heights: 509-954-1465, 509-244-4833 Medical Lake: 509-290-7184

Which YWCA Spokane ECEAP site would you prefer?(필수의)

Downtown Spokane

Airway Heights/West Plains

Medical Lake

Please note, this does not guarantee there are openings at your preferred site.

Today's Date(필수의)

당신의 이름(필수의)

첫 번째 마지막

How did you hear about ECEAP?(필수의)

DCYF website

Community event

Flyer

ECEAP employee

Word of mouth/friends/family

Caseworker

Media

Community agency

Check all that apply.

What is the name of the community agency that told you about ECEAP?(필수의)

If you could choose the length of day for your child's preschool, which option would be best for your child and family?(필수의)

Part Day - about three hours, three or four days a week

School Day - about six hours, four or five days a week

Working Day - available all day, all year, like a child care center

Please note, these options may not all be available in your community this year. Your answer will inform statewide planning.

Child's full legal first, middle and last name:(필수의)

Child's nickname

Child's birthdate(필수의)

Child's gender identity(필수의)

Is this child a member of a tribal nation?(필수의)

Yes

Is this child on an Individualized Education Program (IEP)?(필수의)

Yes

Is this child on an Individualized Family Service Plan (IFSP)?(필수의)

Yes

Is this child's family actively involved in and/or receiving support from Tribal or State Systems including Child Protective Services (CPS), Family Assessment Response (FAR), Indian Child Welfare (ICW), comparable triable services or law enforcement/court system regarding child abuse, neglect, or sexual assault?(필수의)

Yes

Is this child in official foster care?(필수의)

Yes

This means there is a caregiver authorization from a state or tribe that says this is a foster care placement.

Is this child in kinship care with a relative or suitable other, with or without a grant?(필수의)

Yes

Was this child adopted after foster care, kinship care, or after living in an orphanage in another country?(필수의)

Yes

This does not include other types of adoptions not described in the question.

Is this child from a family who is eligible for the USDA Supplemental Nutrition Assistance Program or SNAP, called Basic Food in Washington? (EBT, food stamps, etc.)(필수의)

Yes

What is your housing situation?(필수의)

Language this child speaks?(필수의)

What language other than English does this child speak?(필수의)

Is this child Hispanic or Latino?(필수의)

Yes

Please specify Hispanic/Latino:(필수의)

Select all that apply.

What race(s) do you consider this child?(필수의)

Alaska Native

American Indian

Asian

Black or African American

Native Hawaiian or other Pacific Islander

White

Select all that apply.

Please specify Alaska Native:(필수의)

Aleut (Unangan)

Alutiiq

Athabaskan

Eskimo (Inupiaq or Yupik)

Eyak

Haida

Tlingit

Tsimshian

Other Alaska Native

Select all that apply.

Please specify American Indian:(필수의)

Select all that apply.

Please specify Asian:(필수의)

Select all that apply.

Please specify Native Hawaiian or other Pacific Islander:(필수의)

Select all that apply.

First and last name of the primary contact person for the child:(필수의)

첫 번째 마지막

Primary contact person's relationship to the child:(필수의)

Primary contact person's date of birth:(필수의)

Does the primary contact person need an interpreter to communicate with English speakers?(필수의)

Yes

What language does the primary contact person prefer?(필수의)

Physical address of primary contact person:(필수의)

Street Address Address Line 2 City State ZIP Code

Mailing address of primary contact person, if different than physical address:

Street Address Address Line 2 City State ZIP Code

Phone number of primary contact person:(필수의)

Email address of primary contact person:(필수의)

Are there additional people who may be contacted for this child?(필수의)

Yes

First and last name of 2nd contact person for this child:(필수의)

2nd contact person's relationship to the child:(필수의)

2nd contact person's date of birth:(필수의)

Does the 2nd contact person need an interpreter to communicate with English speakers?(필수의)

Yes

What language does the 2nd contact person prefer?(필수의)

Phone number of 2nd contact person:(필수의)

Email address of 2nd contact person:(필수의)

First and last name of 3rd contact person for this child:

3rd contact person's relationship to the child:

3rd contact person's date of birth:

Does the 3rd contact person need an interpreter to communicate with English speakers?

Yes

What language does the 3rd contact person prefer?

Phone number of 3rd contact person:

Email address of 3rd contact person:

The child applying for ECEAP lives with:(필수의)

One parent/guardian

Two parents/guardians in the same household

Two parents/guardians in separate households

Name of parent/guardian:(필수의)

첫 번째 마지막

Name of second parent/guardian:(필수의)

첫 번째 마지막

Does one household have primary legal custody?(필수의)

Yes

Which parent/guardian has primary legal custody?(필수의)

첫 번째 마지막

Does the parent with primary legal custody have a spouse?(필수의)

Yes

Name of the spouse of the parent with primary legal custody:(필수의)

첫 번째 마지막

Household Members

In this section, please provide the total number of everyone living in the household who may be counted in the family size, including the potential ECEAP student. Staff will collect more information about each household member when they contact you about your application. Staff will use this information to calculate family size to determine State Median Income (SMI). For families temporarily living with relatives or others, do not list the hosts. For families with two households when there is joint custody with no primary parent and no child support, include all the household members in both households. Know that you will be asked to indicate which household each family member is part of when you talk with staff about your application.

Please list your household members and their birthdates.(필수의)

Name

Birthdate

Parent/Guardian Information

The questions in this section provide ECEAP staff with information about the number of hours parent(s)/guardian(s) spend on different activities each week. In the questions below, do not count the same hours in more than one category. For example, do not count the same hours of the week in both employment and WorkFirst, and do not count the same CPS child care hours separtely for two parents.

How many parents/guardians does the ECEAP child have?(필수의)

Name of Parent/Guardian #1:(필수의)

첫 번째 마지막

Parent/Guardian #1's Highest Education Level:(필수의)

Is Parent/Guardian #1 employed?(필수의)

Yes

On average, how many paid hours of work does Parent/Guardian #1 complete weekly?(필수의)

Name of Parent/Guardian #1's employer:(필수의)

Phone number or email of Parent/Guardian #1's employer:(필수의)

Is Parent/Guardian #1 in school or job training?(필수의)

Yes

How many class hours does Parent/Guardian #1 complete each week?(필수의)

How many hours does Parent/Guardian #1 study each week?(필수의)

Choose a number between 1 and 10.

Name of Parent/Guardian #1's school or training organization:(필수의)

Parent/Guardian #1's goal or major in school or job training:(필수의)

Does parent #1 travel between child care and work/school each week?(필수의)

Yes

On average, how many hours does Parent/Guardian #1 travel between child care and work/school each week?(필수의)

Choose a number between 1 and 10.

Does Parent/Guardian #1 have CPS/FAR/ICW child care hours not counted above?(필수의)

Yes

How many additional hours per week of childcare have been approved by CPS/FAR/ICW for Parent/Guardian #1?(필수의)

Does Parent/Guardian #1 have WorkFirst hours not counted above?(필수의)

Yes

How many additional hours per week of WorkFirst activities does Parent/Guardian #1 complete?(필수의)

What activity is completed during these WorkFirst hours for Parent/Guardian #1?(필수의)

Is Parent/Guardian #1 disabled and unable to work?(필수의)

Yes

Name of Parent/Guardian #2:(필수의)

첫 번째 마지막

Parent/Guardian #2's Highest Education Level:(필수의)

Is Parent/Guardian #2 employed?(필수의)

Yes

On average, how many paid hours of work does Parent/Guardian #2 complete weekly?(필수의)

Name of Parent/Guardian #2's employer:(필수의)

Phone number or email of Parent/Guardian #2's employer:(필수의)

Is Parent/Guardian #2 in school or job training?(필수의)

Yes

How many class hours does Parent/Guardian #2 complete each week?(필수의)

How many hours does Parent/Guardian #2 study each week?(필수의)

Choose a number between 1 and 10.

Name of Parent/Guardian #2's school or training organization:(필수의)

Parent/Guardian #2's goal or major in school or job training:(필수의)

Does parent #2 travel between child care and work/school each week?(필수의)

Yes

On average, how many hours does Parent/Guardian #2 travel between child care and work/school each week?(필수의)

Choose a number between 1 and 10.

Does Parent/Guardian #2 have CPS/FAR/ICW child care hours not counted above?(필수의)

Yes

How many additional hours per week of childcare have been approved by CPS/FAR/ICW for Parent/Guardian #2?(필수의)

Does Parent/Guardian #2 have WorkFirst hours not counted above?(필수의)

Yes

How many additional hours per week of WorkFirst activities does Parent/Guardian #2 complete?(필수의)

What activity is completed during these WorkFirst hours for Parent/Guardian #2?(필수의)

Is Parent/Guardian #2 disabled and unable to work?(필수의)

Yes

If either Parent/Guardian #1 or Parent/Guardian #2 has more than 55 hours per week documented in the questions above, explain:

Household Situation and Family Income

Does your household receive subsidized housing, such as a housing voucher or cash assistance for housing?(필수의)

Yes

Does your household currently receive a Working Connections child care subsidy for the child applying for ECEAP?(필수의)

Yes

Is the child applying for ECEAP in foster care, kinship care, or were they adopted after foster or kinship care?(필수의)

Yes

What is the monthly dollar amount of the grant or payment received for foster care, kinship care, or adoption support?(필수의)

How many children are covered by this grant or payment?(필수의)

Did the family of the child applying for ECEAP receive income during the last calendar year or during the previous 12 months?(필수의)

Yes

Please explain why the family of the child applying for ECEAP did not have any income and how basic needs were met:(필수의)

In the questions below, you will provide detailed family income information for the:(필수의)

Previous calendar year

Previous 12 months

Family income sources:(필수의)

Annual W-2 income dollar amount:(필수의)

Please enter a number greater than or equal to 1.

Who in the family receives W-2 income?(필수의)

If multiple people receive income from this source, please list all names and the dollar amounts that each person receives from this income source.

Annual Tax Return (1040) or IRS transcript income dollar amount:(필수의)

Please enter a number greater than or equal to 1.

Who in the family receives Tax Return (1040) or IRS transcript income?(필수의)

If multiple people receive income from this source, please list all names and the dollar amounts that each person receives from this income source.

Annual dollar amount of income from pay stubs for 12 months:(필수의)

Please enter a number greater than or equal to 1.

Do you still receive the income above?(필수의)

Yes

If no, and your circumstances have recently changed, please explain:(필수의)

Loss of wage earner

Divorce or separation

Unplanned job loss

Reduced work hours

Health/Injury

Loss of benefits

Job loss/Lack of access or ability to afford childcare

Similar unexpected circumstance

What is your monthly income?(필수의)

For which month?(필수의)

What is the amount of your total annual income?(필수의)

Previous Enrollment

This child was previously enrolled in:(필수의)

Name of Early Head Start Grantee:(필수의)

첫 번째 마지막

Name of state and provider:(필수의)

Name of Early ECEAP contractor:(필수의)

Name of ECEAP contractor:(필수의)

IEP or Suspected Delay(필수의)

This child has an Individualized Education Program (IEP).

This child has a diagnosed developmental delay or disability with no IEP.

This child completed a developmental screening that recommended referral for further evaluation.

This child has a suspected developmental delay or disability. (No IEP, diagnosis, screening, or completed developmental screening with result, “rescreen needed”.)

None of the above

Check all categories of the IEP.(필수의)

This child will receive IEP services:(필수의)

Within the ECEAP classroom only

During ECEAP hours only, but outside ECEAP classroom

Outside ECEAP hours

IEP Start Date(필수의)

IEP End Date

If ongoing, leave blank.

What school district issued this child's IEP?(필수의)

Has this child been expelled from any early learning program or child care due to behavior? Checking yes will NOT exclude your child. ECEAP serves children with behavior issues.(필수의)

Yes

Additional Questions

We use this information to choose the children who most need ECEAP. All responses will be kept confidential.

Does this child have a household family member who has a chronic physical or mental health condition that severely or moderately impacts their ability to engage in work, school, or family life?(필수의)

Yes

Does this child have a parent who was under age 18 when this child was born?(필수의)

Yes

Does this child have a parent who is a migrant or seasonal agricultural worker? (51% or more of family income is from agricultural work.)(필수의)

Yes

Does this child have a parent who moves with child to engage in traditional cultural practices or employment (seasonal or temporary in agricultural or fishing work)?(필수의)

Yes

Does this child have a parent currently on active duty in the U.S. Military?(필수의)

Yes

Does this child have a parent currently a member of a National Guard unit or a Military Reserve unit?(필수의)

Yes

Does this child have a military parent deployed currently, or within the past 12 months, or for a total of 19 or more months within the child’s lifetime?(필수의)

Yes

Does this child have a family member who attended an Indian Boarding School?(필수의)

Yes

Does this child have a parent who is incarcerated in jail, prison or a detention center?(필수의)

Yes

Has this child experienced the loss of a parent, or primary caregiver, such as by death, abandonment, or deportation?(필수의)

Yes

Has this child experienced the divorce or separation of their parents?(필수의)

Yes

Has this child experienced homelessness within the last 12 months?(필수의)

Yes

Has this child lived in a household with domestic violence, including in-utero?(필수의)

Yes

Has this child lived in a household with substance abuse, including in-utero?(필수의)

Yes

Has this family previously received support and/or been involved in tribal or state systems including CPS/FAR/ICW, or comparable tribal services, or been involved with law enforcement/court system regarding child abuse, neglect, or sexual assault?(필수의)

Yes

Has this child been reunited with parents after foster or kinship care in the past 12 months?(필수의)

Yes

ECEAP received a professional referral for this family.(필수의)

Yes

If yes, which agency made the referral?(필수의)

Health Information

Does this child have a chronic physical or mental health condition that severely impacts child development or attendance?(필수의)

Yes

Unknown

Does this child have a chronic physical or mental health condition that moderately impacts child development or attendance?(필수의)

Yes

Unknown

Was this child born preterm (less than 37 weeks), or weigh less than 5.5 pounds at birth?(필수의)

Yes

Unknown

Does this child have medical insurance or coverage?(필수의)

Yes

Unknown

Medical Insurance/Coverage(필수의)

WA Apple Health for Kids/Provider One Services Card

Military coverage

Private medical insurance

Tribal coverage

Does this child have a regular doctor or medical clinic?(필수의)

Yes

Unknown

Name of clinic or provider:(필수의)

Clinic or provider phone:

Name of Medical Professional

Did this child have a well-child exam within the last 12 months?(필수의)

Yes

Unknown

Date of last well-child exam before applying for ECEAP:

Does this child have dental insurance or coverage?(필수의)

Yes

Unknown

Dental Insurance/Coverage(필수의)

WA Apple Health for Kids/Provider One Services Card

Military coverage

Private dental insurance

Tribal coverage

ABCD (not available in all counties)

Does this child have a regular dental clinic?(필수의)

Yes

Unknown

Name of Dental Clinic:(필수의)

Dental Clinic Phone:

Name of dental professional:

Did this child have a dental screening within the last 6 months?(필수의)

Yes

Unknown

Date of last dental screening before applying for ECEAP:

Note: You may also drop off or mail the paper application, if preferred, to YWCA Spokane, Attention: ECEAP, 930 N Monroe St, Spokane, WA 99201.

Why Choose ECEAP? It's about the whole family.

Through YWCA Spokane, this program provides free education, resources, health and nutrition services, family support, advocacy training, and parent education at three locations within the greater Spokane area for youth 3 and 4 years old and their families.

ECEAP promotes long-term success with school and life by addressing the needs of the whole child within the whole family to ensure that gains are sustained.

Children in programs such as ECEAP are:

healthier when they start kindergarten
more likely to graduate from high school and go onto college
more likely to be employed and to earn more as an adult
less likely repeat a grade in school
less likely to become pregnant as a teen or involved in a crime

(data from Washington State Department of Early Education)

더 알아보기

Want more info before signing up?

If you aren't ready to complete the ECEAP application and prefer to learn more about this program first, please complete the below form. Our staff will be in touch to help you determine if it is a good fit for your child and family.

Interest Form

Other Youth Services

YWCA Spokane provides an array of other services for children and youth.

Drop-in Childcare

Therapy

건강한 뿌리

청소년 위원회

Drop-in Childcare

We provide a drop-in childcare space at our main office location, 930 N Monroe St, where caregivers can drop off their children for a couple hours while on-site using services provided by YWCA Spokane.

Talk with the staff member you are currently working with or plan to work with to learn more.

Therapy

We provided mental health therapy services for youth who have witnessed or been exposed to trauma from an intimate partner domestic violence relationship occurring in the same household.

Therapy for Youth

건강한 뿌리

Learning about healthy and unhealthy relationship dynamics is key to preventing future violence in our community.

That's why we offer Healthy Roots, a free educational series taught to groups of youth at various locations in Spokane.

If you are interested in bringing Healthy Roots to your area, please contact prevention@ywcaspokane.org.

청소년 폭력 예방

청소년 위원회

We believe youth voices should be centered when planning how best to move forward with violence prevention impacting young people in our community.

That's why we created our Teen Council. A space that fosters leadership within our teen community while identifying ways we can move forward in action together.

청소년 위원회

블로그

12월 3, 2024 12월 3 @ 10:53 오후

Mission Moment – Youth Therapy

Healing Together For families who have experienced domestic violence, therapeutic support can provide some relief from experiences of stress, anxiety, and post-traumatic stress disorder (PTSD). YWCA Spokane offers a specialized therapy program for youth 7-18 years old who have second…

12월 2, 2024 12월 3 @ 10:53 오후

December RSJ Spotlight | Salish School of Spokane

Racial & Social Justice Spotlight Series. Each month, YWCA Spokane spotlights an organization or individual in our community that is aligned with our mission so we can highlight the work they do to create real and lasting change for a more equitable Spokane. December spotlight, LaRae Wiley and Christopher Parkin, Salish School of Spokane.

11월 20, 2024 12월 3 @ 10:53 오후

Support Survivors this Holiday Season

Give Today For many, holidays are a time filled with warmth, joy, friendship, and good food. It always leaves me reflecting on what love, comfort, and hope mean for our community and those that YWCA Spokane serves. As I spend…

이벤트

11월 1, 2024 11월 1 - 12월 6

2024 Hope for the Holidays Event

11월 14, 2024 12월 10 @ 10:00 오전 - 오전 11:30

DV 101 훈련: 인식. 대답하다. 나타내다.

Join YWCA Spokane for this important free, virtual training on December 10th. Learn more about intimate partner domestic violence, how to help a friend, and about YWCA Spokane’s free and confidential services.

10월 29, 2024 12월 14 @ 1:30 오후 - 4:00 오후

찾다

따르다

Apply for Free Pre-School

Online Application

Apply for Free Pre-School

ECEAP Application

If you would like help filling out this application, please contact a Family Service Advocate!

Household Members

Parent/Guardian Information

Household Situation and Family Income

Previous Enrollment

Additional Questions

Health Information

Why Choose ECEAP? It's about the whole family.

Want more info before signing up?

Other Youth Services

블로그

Mission Moment – Youth Therapy

December RSJ Spotlight | Salish School of Spokane

Support Survivors this Holiday Season

이벤트

2024 Hope for the Holidays Event

DV 101 훈련: 인식. 대답하다. 나타내다.

2024 Youth Self-Care Summit

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