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?(Required)

Downtown Spokane

Airway Heights/West Plains

Medical Lake

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

Today's Date(Required)

Your Name(Required)

First Last

How did you hear about ECEAP?(Required)

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?(Required)

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

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:(Required)

Child's nickname

Child's birthdate(Required)

Child's gender identity(Required)

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

Yes

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

Yes

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

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?(Required)

Yes

Is this child in official foster care?(Required)

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?(Required)

Yes

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

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.)(Required)

Yes

What is your housing situation?(Required)

Language this child speaks?(Required)

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

Is this child Hispanic or Latino?(Required)

Yes

Please specify Hispanic/Latino:(Required)

Select all that apply.

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

Alaska Native

American Indian

Asian

Black or African American

Native Hawaiian or other Pacific Islander

White

Select all that apply.

Please specify Alaska Native:(Required)

Aleut (Unangan)

Alutiiq

Athabaskan

Eskimo (Inupiaq or Yupik)

Eyak

Haida

Tlingit

Tsimshian

Other Alaska Native

Select all that apply.

Please specify American Indian:(Required)

Select all that apply.

Please specify Asian:(Required)

Select all that apply.

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

Select all that apply.

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

First Last

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

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

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

Yes

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

Physical address of primary contact person:(Required)

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:(Required)

Email address of primary contact person:(Required)

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

Yes

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

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

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

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

Yes

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

Phone number of 2nd contact person:(Required)

Email address of 2nd contact person:(Required)

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:(Required)

One parent/guardian

Two parents/guardians in the same household

Two parents/guardians in separate households

Name of parent/guardian:(Required)

First Last

Name of second parent/guardian:(Required)

First Last

Does one household have primary legal custody?(Required)

Yes

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

First Last

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

Yes

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

First Last

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.(Required)

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?(Required)

Name of Parent/Guardian #1:(Required)

First Last

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

Is Parent/Guardian #1 employed?(Required)

Yes

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

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

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

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

Yes

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

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

Choose a number between 1 and 10.

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

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

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

Yes

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

Choose a number between 1 and 10.

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

Yes

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

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

Yes

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

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

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

Yes

Name of Parent/Guardian #2:(Required)

First Last

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

Is Parent/Guardian #2 employed?(Required)

Yes

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

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

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

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

Yes

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

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

Choose a number between 1 and 10.

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

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

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

Yes

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

Choose a number between 1 and 10.

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

Yes

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

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

Yes

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

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

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

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?(Required)

Yes

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

Yes

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

Yes

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

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

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

Yes

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

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

Previous calendar year

Previous 12 months

Family income sources:(Required)

Annual W-2 income dollar amount:(Required)

Please enter a number greater than or equal to 1.

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

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:(Required)

Please enter a number greater than or equal to 1.

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

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:(Required)

Please enter a number greater than or equal to 1.

Do you still receive the income above?(Required)

Yes

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

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?(Required)

For which month?(Required)

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

Previous Enrollment

This child was previously enrolled in:(Required)

Name of Early Head Start Grantee:(Required)

First Last

Name of state and provider:(Required)

Name of Early ECEAP contractor:(Required)

Name of ECEAP contractor:(Required)

IEP or Suspected Delay(Required)

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.(Required)

This child will receive IEP services:(Required)

Within the ECEAP classroom only

During ECEAP hours only, but outside ECEAP classroom

Outside ECEAP hours

IEP Start Date(Required)

IEP End Date

If ongoing, leave blank.

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

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.(Required)

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?(Required)

Yes

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

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.)(Required)

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)?(Required)

Yes

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

Yes

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

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?(Required)

Yes

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

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

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?(Required)

Yes

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

Yes

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

Yes

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

Health Information

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

Yes

Unknown

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

Yes

Unknown

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

Yes

Unknown

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

Yes

Unknown

Medical Insurance/Coverage(Required)

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?(Required)

Yes

Unknown

Name of clinic or provider:(Required)

Clinic or provider phone:

Name of Medical Professional

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

Yes

Unknown

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

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

Yes

Unknown

Dental Insurance/Coverage(Required)

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?(Required)

Yes

Unknown

Name of Dental Clinic:(Required)

Dental Clinic Phone:

Name of dental professional:

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

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)

Learn More

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

Healthy Roots

Teen Council

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

Healthy Roots

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.

Youth Violence Prevention

Teen Council

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.

Teen Council

Blog

Dec 3, 2024 Dec 11 @ 11:51 am

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…

Dec 2, 2024 Dec 11 @ 11:51 am

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.

Nov 20, 2024 Dec 11 @ 11:51 am

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…

Events

Oct 29, 2024 Dec 14 @ 1:30 pm - 4:00 pm

2024 Youth Self-Care Summit

Dec 10, 2024 Jan 14, 2025 @ 10:00 am - 11:30 am

DV 101 Training: Recognize. Respond. Refer.

Join YWCA Spokane for this important free, virtual training on January 14th at 10:00am. Learn more about intimate partner domestic violence, how to help a friend, and about YWCA Spokane’s free and confidential services.

Dec 9, 2024 Jan 20, 2025 @ 11:00 am - 3:00 pm

2025 Martin Luther King Jr. Rally & March

January 20, 2025 Spokane Convention Center Join us! Open to the community, feel free to march with YWCA. Details to come.

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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

Blog

Mission Moment – Youth Therapy

December RSJ Spotlight | Salish School of Spokane

Support Survivors this Holiday Season

Events

2024 Youth Self-Care Summit

DV 101 Training: Recognize. Respond. Refer.

2025 Martin Luther King Jr. Rally & March

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