ECEAP Application and Prescreen (combined form) Request
Please complete the information below for the ECEAP program and we will send you the combined application to complete and turn into NEWESD 101 with the verification documents. In the meantime, please gather verification documents that include child's date of birth, child's immunization records, and parent's income (2019 tax return works best) and/or other income information.
School Year of Interest *
Child must be 3 or 4 years old by August 31 of the year applying. Note: for the 2020-2021 School Year, we will send you the application starting in April, 2020 when we begin recruitment for next school year.
1. Child's Full Name: *
2. Child's Date of Birth (MM/DD/YYYY): *
3. Site of Interest: *
4. Parent/Guardian Full Name: *
5. Mailing Street Address, City, State, Zip Code (including apartment number) *
Contact Phone Number *
Contact Email *
Do you want materials mailed or emailed to you? *
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