Thank you for your interest in our Early Programs! Please complete this pre-application as completely as possible to help us determine the best placement for your child. Intentionally leaving information blank could delay the processing of your pre-application. Income should be your best estimate at the time of filling out this pre-application.
If you have any questions or concerns about your application, please call us at 360.782.5065 or email ersea@oesd114.org and we can help you with next steps. If is your preference you may also fill out your application on paper and in-person.
Thank you for your interest in the program.
*Pregnant Mothers Applying - Under child application, you will be answering questions about your child as if they have already been delivered. For instance, Child's Date of Birth will be your expected due date.
Parent/Guardian
Please complete this section for the primary parent/guardian of this child.
First Name (Required)
Middle Name
Last Name (Required)
Birthday (Required)
Gender
Female
Male
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
Opt In for Text Messages
Yes
No
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.
Race
American Indian or Alaska Native
Asian
Black or African American
Multi-racial/Biracial
Native Hawaiian/Other Pacific Islander
Other
Unspecified
White
Hispanic
Yes
No
English Proficiency
Little
Moderate
None
Proficient
Other Language
Acholi
American Sign Language
Arabic
Cambodian
Cantonese
Chamorro
Chinese
Chuj
Chuukese
Creole
English
Ewe
Farsi
Filipino
German
Hindi
Hmong
Hungarian
Igbo
Japanese
Kanjobal
Korean
Kurdish
Mam
Nepali
Polish
Puanjobas
Punjabi
Quiche
Russian
Samoan
Slovak
Spanish
Swahili
Tagalog
Tigrinya
Turkish
Urdu
Vietnamese
Other Language Proficiency
Little
Moderate
None
Proficient
Highest Grade Completed
Associate's Degree
Bachelor's Degree
College Degree/Training Cert.
Grade 10
Grade 11
Grade 12
Grade 9 or less
High School Diploma or GED
Master's Degree
Some College
Employment Status
Full-time & Training
Full-time (35 hours/week or more)
Part-time & Training
Part-time (Under 35 hours/week)
Retired or Disabled
Seasonally Employed
Training or School
Unemployed
Child's Relationship
Biological/Adopted/Step
Foster
Grandchild
Other
Other Relative
Custody
Yes
No
Lives with Family
Yes
No
Provides Financial Support
Yes
No
Address
Is your family experiencing homelessness?
Yes
No
Living Address (Required)
Address Line 2
City (Required)
State (Required)
ZIP (Required)
Click here
to find a provider in your area.
Mailing Address same as Living Address
Mailing Address
Address Line 2
City
State
ZIP
Additional Parent/Guardian
Is there another parent/guardian in the family?
Yes
No
First Name (Required)
Middle Name
Last Name (Required)
Birthday (Required)
Gender
Female
Male
Email Address
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
Opt In for Text Messages
Yes
No
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.
Race
American Indian or Alaska Native
Asian
Black or African American
Multi-racial/Biracial
Native Hawaiian/Other Pacific Islander
Other
Unspecified
White
Hispanic
Yes
No
English Proficiency
Little
Moderate
None
Proficient
Other Language
Acholi
American Sign Language
Arabic
Cambodian
Cantonese
Chamorro
Chinese
Chuj
Chuukese
Creole
English
Ewe
Farsi
Filipino
German
Hindi
Hmong
Hungarian
Igbo
Japanese
Kanjobal
Korean
Kurdish
Mam
Nepali
Polish
Puanjobas
Punjabi
Quiche
Russian
Samoan
Slovak
Spanish
Swahili
Tagalog
Tigrinya
Turkish
Urdu
Vietnamese
Other Language Proficiency
Little
Moderate
None
Proficient
Highest Grade Completed
Associate's Degree
Bachelor's Degree
College Degree/Training Cert.
Grade 10
Grade 11
Grade 12
Grade 9 or less
High School Diploma or GED
Master's Degree
Some College
Employment Status
Full-time & Training
Full-time (35 hours/week or more)
Part-time & Training
Part-time (Under 35 hours/week)
Retired or Disabled
Seasonally Employed
Training or School
Unemployed
Child's Relationship
Biological/Adopted/Step
Foster
Grandchild
Other
Other Relative
Custody
Yes
No
Lives with Family
Yes
No
Provides Financial Support
Yes
No
Family Information
Number of Parents/Guardians
One Parent Family
Two Parent Family
Relationship to Participant(s)
Foster parent(s) not including relatives
Grandparent(s)
Other
Parent(s) (e.g. biological, adoptive, stepparents)
Relative(s) other than grandparents
Primary Language at Home
Acholi
American Sign Language
Arabic
Cambodian
Cantonese
Chamorro
Chinese
Chuj
Chuukese
Creole
English
Ewe
Farsi
Filipino
German
Hindi
Hmong
Hungarian
Igbo
Japanese
Kanjobal
Korean
Kurdish
Mam
Nepali
Polish
Puanjobas
Punjabi
Quiche
Russian
Samoan
Slovak
Spanish
Swahili
Tagalog
Tigrinya
Turkish
Urdu
Vietnamese
Is another language being acquired or learned at home?
Yes
No
Number in Household
Number in Family
Gross Annual Income
Is your family receiving cash benefits or other services under the Temporary Assistance for Needy Families (TANF) program?
Yes
No
Is your family receiving Supplemental Security Income (SSI)?
Yes
No
Is your family receiving services from WIC?
Yes
No
Is your family receiving services under the Supplemental Nutrition Assistance Program (SNAP), formerly referred to as Food Stamps?
Yes
No
Child (Applicant)
First Name (Required)
Middle Name
Last Name (Required)
Nickname
Birthday (Required)
Gender
Female
Male
Race
American Indian or Alaska Native
Asian
Black or African American
Multi-racial/Biracial
Native Hawaiian/Other Pacific Islander
Other
Unspecified
White
Hispanic
Yes
No
English Proficiency
Little
Moderate
None
Proficient
Other Language
Acholi
American Sign Language
Arabic
Cambodian
Cantonese
Chamorro
Chinese
Chuj
Chuukese
Creole
English
Ewe
Farsi
Filipino
German
Hindi
Hmong
Hungarian
Igbo
Japanese
Kanjobal
Korean
Kurdish
Mam
Nepali
Polish
Puanjobas
Punjabi
Quiche
Russian
Samoan
Slovak
Spanish
Swahili
Tagalog
Tigrinya
Turkish
Urdu
Vietnamese
Other Language Proficiency
Little
Moderate
None
Proficient
Is there anything else you want to tell us about your child?
Location Preferences
Which program are you applying for? (Required)
Preschool for Children Ages 3 to 5
Pregnancy to 3 Years Old
1st Location Preference
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2nd Location Preference
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- Your Address
- Available Locations
Click a location on the map to see more info
Click here
to find a provider in your area.
Additional Applicant
Do you want to apply now for another child in your family?
Add Another Applicant
Siblings
Are there other children in the family?
Add a Sibling
By clicking Save and Continue you are submitting your Family Pre-Application. The next page will send you to a separate and secure website for uploading your required age and income documentation. We will be contacting you to complete the application process. We will also send you an email with further instructions. If you have any questions or concerns about your application, please call us at 360.782.5065 or email ersea@oesd114.org and we can help you with next steps. If is your preference you may also fill out your application on paper and submit documentation in-person.
Required information is missing, see above.