Apply Online

Thank you for your interest in the Sheltering Arms. Please note, completing an application DOES NOT guarantee enrollment in the program. This pre-screening application starts the process of determining your eligibility. Please read and answer each question that is applicable to your family. If you have previously submitted an online application, DO NOT attempt to reenter or submit a new application. It will cause errors and delay the process.

Please answer questions about education, employment and income based on the date of the application. For teen parents, only enter "Yes" if 19 years or younger on the date of application.

First Name (Required)

Middle Name

Last Name (Required)

Birthday (Required)

Gender

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

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

Hispanic

English Proficiency

Other Language

Highest Grade Completed

Employment Status

Child's Relationship

Custody

Lives with Family

Provides Financial Support

Teen Parent

You must provide your current address. Sheltering Arms cannot accept a P.O. Box as your living address.

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.

Mailing Address same as Living Address

Mailing Address

Address Line 2

City

State

ZIP

Only complete this section if the Secondary Adult is currently living in the home, being supported by the same income, and related by blood, marriage or adoption to the child you are applying for.

Is there another parent/guardian in the family?

First Name (Required)

Middle Name

Last Name (Required)

Birthday (Required)

Gender

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

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

Hispanic

English Proficiency

Other Language

Highest Grade Completed

Employment Status

Child's Relationship

Custody

Lives with Family

Provides Financial Support

Teen Parent

For number in family: Sheltering Arms define family as all persons living in the same household who are supported by the child’s parent(s)’ or guardian(s)’ income; and are related to the child’s parent(s) or guardian(s) by blood, marriage, or adoption; or are the child’s authorized care giver or legally responsible party. Please answer "Yes" for TANF, SNAP and WIC if you are currently receiving these benefits. 1st Example: Mother lives with father (blood, marriage, adoption, or legal guardian) and they both provide financial support for three children. The number in the family is five.

Number of Parents/Guardians

Relationship to Participant(s)

Primary Language at Home

Is another language being acquired or learned at home?

Number in Family

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

Is your family receiving Supplemental Security Income (SSI)?

Is your family receiving services from WIC?

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

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

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

Add Emergency Contact

If your child has an IEP or IFSP, chronic condition like asthma, diabetes, seizures, allergies, dietary restrictions please enter the details in the notes at the end of the application and upload supporting documents in the upload attachments section.

First Name (Required)

Middle Name

Last Name (Required)

Suffix

Nickname

Birthday (Required)

Gender

Race

Hispanic

English Proficiency

Other Language

Other Language Proficiency

Primary Health Coverage

Other Coverage

Medicaid Eligibility

Doctor/Medical Home

Dental Coverage

Dentist/Dental Home

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

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

Which program are you applying for? (Required)

1st Location Preference

2nd 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

After you select save and continue you will be asked to upload your supporting documents. The next screen is the "Upload Document" screen. You can use saved files or take a picture of the documents and upload them using your cell phone or computer. If you do not currently have the documents, you can submit them during the second step of the application. PLEASE NOTE: Your application cannot be processed without the required supporting documents (proof of age, proof of residency and proof of income). If all requested documents have been submitted, you can skip the upload step. Now select save and continue.

Required information is missing, see above.

Parent/Guardian

Address

Additional Parent/Guardian

Family Information

Emergency Contacts

Child (Applicant)

Location Preferences

Additional Applicant

Siblings