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Thank you for your interest in enrolling our Bridge to Hope Program. We are excited to learn more about your family! Please complete this Family Pre-Application as accurately and completely as possible. The information you provide will help us determine your family's eligibility and begin the enrollment process. Before you begin: 1. Allow approximately 15–20 minutes to complete the application. 2. Have your household and your child's information available. 3. Answer every required question honestly and completely. 4. If a question does not apply to your family, select "N/A" or leave it blank if allowed. 5. Double-check your contact information to ensure we can reach you. 6. Submitting this application does not guarantee entrance into our programming. A member of our team will review your application and contact you regarding eligibility and next steps. If you need assistance completing this application or have questions, please contact us at enrollment@vogelalcove.org. We are happy to help! Thank you for choosing Vogel. We look forward to partnering with your family and building your Bridge to Hope.

Please complete this section with information for the primary adult who is enrolling in Bridge to Hope. Please complete all required fields accurately.

First Name (Required)

Last Name (Required)

Birthday (Required)

Gender (Required)

Email Address (Required)

Confirm Email Address

It appears that you have previously submitted an application. If you wish to apply again, please contact us by phone or in person.

Mobile Phone

Home Phone

Work Phone

Ext.

It appears that you have previously submitted an application. If you wish to apply again, please contact us by phone or in person.

SSN

Race and/or Ethnicity - To specify multiracial and/or multiethnic please check all races and/or ethnicities that apply (Required)

American Indian or Alaska Native

Asian

Black or African American

Hispanic or Latino

Middle Eastern or North African

Native Hawaiian or Pacific Islander

White

Lives with Family

Other Language

Highest Grade Completed (Required)

Employment Status (Required)

Child's Relationship

Custody

Teen Parent

Housing (Required)

# of moves last 60 days (Required)

# of months at address (Required)

Explain Housing Status (Required)

Please enter your current home address where your family lives most of the time. Include your street address, apartment or unit number (if applicable), city, state, and ZIP code. If your mailing address is different from your home address, please provide that information where requested.

Is your family experiencing homelessness?

Living Address (Required)

Address Line 2

City (Required)

State (Required)

ZIP (Required)

Click here to find a provider in your area.

Complete this section only if there is a second adult who lives in the child's household or shares responsibility for the child's care. This may include a parent, legal guardian, spouse, partner, or another adult caregiver. If there is no secondary adult, you may leave this section blank.

Is there another parent/guardian in the family?

First Name (Required)

Last Name (Required)

Birthday (Required)

Gender (Required)

Email Address (Required)

Confirm Email Address

It appears that you have previously submitted an application. If you wish to apply again, please contact us by phone or in person.

Mobile Phone (Required)

Home Phone (Required)

Work Phone (Required)

Ext.

It appears that you have previously submitted an application. If you wish to apply again, please contact us by phone or in person.

SSN

Race and/or Ethnicity - To specify multiracial and/or multiethnic please check all races and/or ethnicities that apply (Required)

American Indian or Alaska Native

Asian

Black or African American

Hispanic or Latino

Middle Eastern or North African

Native Hawaiian or Pacific Islander

White

Lives with Family

Other Language

Highest Grade Completed (Required)

Employment Status (Required)

Child's Relationship

Custody

Provides Financial Support

Teen Parent

Are there other adults in the household?

Add Another Adult

Number of Parents/Guardians (Required)

Relationship to Participant(s) (Required)

Primary Language at Home (Required)

Is another language being acquired or learned at home?

Number in Household (Required)

Number in Family (Required)

Gross Annual Income (Required)

Is your family receiving cash benefits or other services under the Temporary Assistance for Needy Families (TANF) program? (Required)

Is your family receiving Supplemental Security Income (SSI)? (Required)

Is your family receiving services from WIC? (Required)

WIC ID (if applicable)

Is your family receiving services under the Supplemental Nutrition Assistance Program (SNAP), formerly referred to as Food Stamps? (Required)

Is at least one parent/guardian an active duty member of the United States military? (Required)

Is at least one parent/guardian a veteran of the United States military? (Required)

Add Emergency Contact

Please complete this section with information about the child you are applying to enroll in Vogel's Early Childhood Education Program. Provide all requested information accurately, including the child's legal name, date of birth, gender, race and ethnicity, primary language, and any other required details.

First Name (Required)

Middle Name

Last Name (Required)

Suffix

Nickname

Birthday (Required)

Gender (Required)

SSN

Race and/or Ethnicity - To specify multiracial and/or multiethnic please check all races and/or ethnicities that apply (Required)

American Indian or Alaska Native

Asian

Black or African American

Hispanic or Latino

Middle Eastern or North African

Native Hawaiian or Pacific Islander

White

Lives with Family

Other Language

Primary Health Coverage (Required)

Other Coverage

Insurance Number

Medicaid Eligibility (Required)

Medicaid Number

Doctor/Medical Home

Dental Coverage

Dental Coverage Number

Dentist/Dental Home

Does your child have a disability or do you have any concerns about your child's development? (Required)

Is there anything else you want to tell us about your child?

Which program are you applying for? (Required)

Location Preference

1st Location Preference

2nd Location Preference

3rd Location Preference

- Your Address - Available Locations

Click a location on the map to see more info

Click here to find a provider in your area.

Do you want to apply now for another child in your family?

Add Another Applicant

Are there other children in the family?

Add a Sibling

Thank you for your interest in Vogel Bridge to Hope. By clicking the Submit button below, you certify that the information provided is true, complete, and correct to the best of your knowledge. A member of our Enrollment team will review the information and contact you to discuss the next steps in the application process. We appreciate your interest in Vogel and look forward to the opportunity to partner with your family to build your Bridge to Hope.

Required information is missing, see above.

Parent/Guardian

Address

Additional Parent/Guardian

Other Adults

Family Information

Emergency Contacts

Child (Applicant)

Location Preferences

Additional Applicant

Siblings