ERSEA PLAN 2017-2018

Andrews HS**/EHS*** 1231 E Chapman

Fullerton, CA 92831 714-888-1201

Baden Powell HS*/**/EHS***

801 S. Gaymont St. Anaheim, CA 92804

714-236-4224

Buena Park HS*/** 6725 Dale St.

Buena Park, CA 90621 714-521-1909

Buena Park EHS***

6625 Dale St. Buena Park, CA 90621

714-367-1111

Capo HS* 31485 El Camino Real

San Juan Capistrano, CA 92675 949-661-8029

Carver HS *

11150 Santa Rosalia St. Stanton, CA 90680

714-598-6411

Centralia HS*/** 6627 La Cienega Dr.

Buena Park, CA 90620 714-228-9004

Crescent EHS***

5600 Crescent Ave. Buena Park, CA 90620

714-699-5930

Delhi HS*/** 505 E. Central Ave.

Santa Ana, CA 92707 714-361-8866

Doris L. Wood HS*

10871 Acacia Parkway Garden Grove, CA 92840

714-241-8920

E.L.V. HS**/EHS*** 32204 Del Obispo St.

San Juan Capistrano, CA 92675 949-661-5243

Franklin HS*/**/EHS***

506 South Janss St. Anaheim, CA 92805

714-399-2100

Fourth St. EHS*** 1626 E. 4th St.

Santa Ana, CA 92701 714-619-7900

Fullerton HS*/**

341 S. Courtney Ave. Fullerton, CA 92833

714-447-3005

Hope HS*/** 13841 Milton Ave.

Westminster, CA 92683 714-230-3832

Jeanne Hardy HS*/**/EHS***

17175 Emerald Ln. Huntington Beach,

CA 92647 714-842-1221

K.I.D.S. HS**/EHS***

1002 W. 2nd St. Santa Ana, CA 92703

714-541-8164

Lambert HS*/**/EHS*** 1060 W. Lambert Rd. La Habra, CA 90631

714-241-8920

Martin HS*/** 1008 W. Russell Ave. Santa Ana, CA 92707

714-427-1290

Matt Kline HS*/**/EHS*** 2043 Meyer Pl.

Costa Mesa, CA 92627 949-548-4480

Placentia HS*/**

840 S. Melrose St. Placentia, CA 92870

714-632-8787

Ruby Dr. EHS*** 601 Ruby Dr.

Placentia, CA 92870 714-854-8787

Schweitzer HS*/**/EHS***

211 S. Dale Ave. Anaheim, CA 92804

714-229-8790

Stanton HS*/** 8050 Chapman Ave. Stanton, CA 90680

714-230-3814

Topaz HS*/**/EHS*** 1600 Sapphire Rd. Fullerton, CA 92831

714-854-1534

Walter HS*/** 9200 Pacific Place

Anaheim, CA 92804 714-761-4967

OCHS Head Start and Early Head Start Home

Base Programs

* Part Day Program Available

** Full Day Program Available

*** Early Head Start Available

Application Documentation Checklist

Thank you for your interest in Orange County Head Start Inc.’s (OCHS) School Readiness Program. The following documents are needed in order for us to process your application:

Proof of Birth Date

Birth Certificate

Passport

Hospital Birth Certificate

Foster Care Documents

Court orders regarding child custody

Adoption Documents

Proof of Pregnancy - Physician Letter

Proof of Income One year of income or, at minimum, one month of income for each parent in the household

1040 Income Tax Return 2016

All 2016 W-2s

Pay stubs (one year of income or, at minimum, one month of income) (cannot be older than one

month from the date of the complete application)

SSI (must be less than 3 months old from the date of the complete application)

TANF Cash Aid (must be less than 3 months old from the date of the complete application)

Adoption Assistance (cannot be older than one month from the date of the complete application)

Foster Care Documents

Grants/Scholarships (per semester or quarter)

Child Support (cannot be older than one month from the date of the complete application)

Unemployment (cannot be older than one month from the date of the complete application)

Disability (cannot be older than one month from the date of the complete application)

Cash payments (Must Complete an OCHS Self- Declaration Form)

1099-MISC

Social Security (cannot be older than one month from the date of the complete application)

Letter from a person providing financial assistance for the family

Military Pay

Immunizations (Up-to-date Records)

Proof of Identified Disability (for child, if applicable)

Individual Education Plan (IEP)

Individual Family Service Plan (IFSP)

Proof of Medical Insurance (if covered)

Child’s Medical Insurance Card

Full Time Eligibility Verification Form

If applying for Head Start or Early Head Start full-day center base program

Must be working 20+ hours Monday-Friday or attending school full time (at least 12 units) to be

eligible for this program option.

Please bring all required documents to the nearest OCHS Center or Administration Office. We

look forward to assisting you!

Administration Office 2501 S. Pullman Street, Ste. 100 ● Santa Ana, CA 92705 ● 714-241-8920 ● efax 714-640-2332

ERSEA PLAN 2017-2018

Lista de Información para la Aplicación

Gracias por su interés en Orange County Head Start, Inc.’s (OCHS) Programa de Preparación Escolar. Para poder procesar su aplicación necesitamos los siguientes documentos:

Prueba de fecha de nacimiento o prueba de embarazo

Certificado de nacimiento

Pasaporte

Certificado del hospital

Documentos de cuidado de crianza temporal

Ordenes de la corte sobre custodia de los hijos

Documentos de adopción

Nota del médico (para solicitantes de embarazo)

Prueba de Ingresos- Salario de todo un año o por lo menos ingresos de un mes de cada padre

Declaración de impuestos 1040 del 2016

Todos los W-2 del 2016

Talones de cheque (salario de un año o el valor de un mes) (No pueden ser más de un mes de la

fecha de cuando aplico)

Seguridad social (debe ser menos de tres meses desde la fecha de la aplicación)

Ayuda monetaria (Cash Aid TANF), o Ingresos del seguro social (SSI) (debe ser menos de tres

meses desde la fecha de la aplicación)

Asistencia de adopción (debe ser menos de un mes desde la fecha de la aplicación)

Reembolso de cuidado de crianza temporal (acuerdo de cuidado de crianza y documentos

legales)

Becas (por semestre o trimestre)

Manutención de menores (debe ser menos de un mes desde la fecha de la aplicación)

Desempleo/Discapacidad (debe ser menos de un mes desde la fecha de la aplicación)

Forma de declaración de ingresos (debe completar la forma de declaración de OCHS)

Forma 1099 para trabajadores por cuenta propia

Social Security (debe ser menos de un mes desde la fecha de la aplicación)

Carta de la persona que esta manteniendo a la familia

Paga militar

Inmunizaciones - Registro actualizado

Prueba de discapacidad identificada (si es aplicable)

Plan Educativo Individual (IEP) o

Plan de Servicio Individual Familiar (IFSP)

Prueba de aseguranza medica- (si esta cubierto)

Tarjeta de aseguranza medica Para clases de tiempo completo o el programa de Early Head Start en el centro

La forma—Full-Time Employment Verification Form es necesaria (pida esta forma en el centro)

Tiene que estar trabajando tiempo completo 20+ horas o mas Lunes a Viernes o asistiendo a la escuela tiempo completo con 12+ unidades para calificar

Por favor de traer todos los documentos al centro mas cercano o a la Oficina

Administrativa de OCHS. ¡Esperamos poder ayudarle!

Oficina Administrativa 2501 S. Pullman Street, Ste. 100 ● Santa Ana, CA 92705 ● 714-241-8920 ● efax 714-640-2332

Andrews HS**/EHS*** 1231 E Chapman

Fullerton, CA 92831 714-888-1201

Baden Powell HS*/**/EHS***

801 S. Gaymont St. Anaheim, CA 92804

714-236-4224

Buena Park HS*/** 6725 Dale St.

Buena Park, CA 90621 714-521-1909

Buena Park EHS***

6625 Dale St. Buena Park, CA 90621

714-367-1111

Capo HS* 31485 El Camino Real

San Juan Capistrano, CA 92675 949-661-8029

Carver HS *

11150 Santa Rosalia St. Stanton, CA 90680

714-598-6411

Centralia HS*/** 6627 La Cienega Dr.

Buena Park, CA 90620 714-228-9004

Crescent EHS***

5600 Crescent Ave. Buena Park, CA 90620

714-699-5930

Delhi HS*/** 505 E. Central Ave.

Santa Ana, CA 92707 714-361-8866

Doris L. Wood HS*

10871 Acacia Parkway Garden Grove, CA 92840

714-241-8920

E.L.V. HS**/EHS*** 32204 Del Obispo St.

San Juan Capistrano, CA 92675 949-661-5243

Franklin HS*/**/EHS***

506 South Janss St. Anaheim, CA 92805

714-399-2100

Fourth St. EHS*** 1626 E. 4th St.

Santa Ana, CA 92701 714-619-7900

Fullerton HS*/**

341 S. Courtney Ave. Fullerton, CA 92833

714-447-3005

Hope HS*/** 13841 Milton Ave.

Westminster, CA 92683 714-230-3832

Jeanne Hardy HS*/**/EHS***

17175 Emerald Ln. Huntington Beach,

CA 92647 714-842-1221

K.I.D.S. HS**/EHS***

1002 W. 2nd St. Santa Ana, CA 92703

714-541-8164

Lambert HS*/**/EHS*** 1060 W. Lambert Rd. La Habra, CA 90631

714-241-8920

Martin HS*/** 1008 W. Russell Ave. Santa Ana, CA 92707

714-427-1290

Matt Kline HS*/**/EHS*** 2043 Meyer Pl.

Costa Mesa, CA 92627 949-548-4480

Placentia HS*/**

840 S. Melrose St. Placentia, CA 92870

714-632-8787

Ruby Dr. EHS*** 601 Ruby Dr.

Placentia, CA 92870 714-854-8787

Schweitzer HS*/**/EHS***

211 S. Dale Ave. Anaheim, CA 92804

714-229-8790

Stanton HS*/** 8050 Chapman Ave. Stanton, CA 90680

714-230-3814

Topaz HS*/**/EHS*** 1600 Sapphire Rd. Fullerton, CA 92831

714-854-1534

Walter HS*/** 9200 Pacific Place

Anaheim, CA 92804 714-761-4967

OCHS Head Start and Early Head Start Home

Base Programs

* Part Day Program Available

** Full Day Program Available

*** Early Head Start Available

ERSEA PLAN 2017-2018

Administration Office 2501 S. Pullman Street, Ste. 100 ● Santa Ana, CA 92705 ● 714-241-8920 ● efax 714-640-2332

Danh Sach Cac Chưng Tư Kem theo Đơn Xin Nhâp Hoc

Cam ơn qui vi đa quan tâm đên Head Start Quân Cam (OCHS) Chương trinh Săn Sang Vao Lơp Mâu Giao. Nhưng chưng tư cân thiêt theo thư tư sau đây đê chung tôi duyêt xet đơn xin nhâp hoc cua con em qui vi:

Chưng Nhân Khai Sinh

Giây Khai Sinh

Sô Thông Hanh (Passport)

Giây Khai Sinh Bênh Viên

Giây Tơ Cha Me Nuôi

An Lênh Toa An nhân Con Nuôi

Giây Tơ Nhân Con Nuôi

Giây Xac Nhân Co Thai - La Thư cua Bac Si

Giây Chưng Minh Lơi Tưc (Lơi tưc môt năm, hay, tôi thiêu, môt thang lương cua môi ngươi Cha, ngươi Me trong gia đinh)

Khai Thuê Lơi Tưc 1040 2016

Tât ca W-2 cua Lơi Tưc Năm 2016

Chi Phiêu Lương (lơi tưc môt năm hay, tôi thiêu lơi tưc môt thang lương) (Lơi tưc thang mơi nhât tinh tư ngay nôp đơn, không tinh phiêu lương cu hơn môt thang)

SSI (Giây Tiên Binh không qua 3 thang tinh tư ngay nôp đơn )

TANF (Giây chưng nhân lanh tiên trơ câp phai dươi 3 thang tinh tư ngay nôp đơn)

Trơ Câp Con Nuôi (không đươc qua môt thang tinh tư ngay nôp đơn)

Giây Chưng Nhân Cha Me Nuôi

Trơ Câp/Hoc Bông (Môi Hoc Ky hay Ba Thang)

Tiên Câp Dương Con Cai (không thê qua môt thang tinh tư ngay nôp đơn)

Tiên Thât Nghiêp (không thê qua môt thang tinh tư ngay nôp đơn)

Khuyêt Tât (không thê qua môt thang tinh tư ngay nôp đơn)

Lam Tiên Măt (Phai điên Mâu OCHS Self- Declaration)

1099-MISC

Tiên An Sinh Xa Hôi (không thê qua môt thang tinh tư ngay nôp đơn)

La thư tư ngươi cung câp tai chanh trơ câp cho gia đinh

Lương Quân Đôi

Giây Chich Ngưa (Hô Sơ Chich Ngưa đươc câp nhât)

Giây Chưng Nhân Khuyêt Tât (cua tre, nêu co) Hô Sơ Giao Duc Ca Nhân (IEP)

Hô Sơ Giao Duc Ca Nhân Gia Đinh (IFSP)

The Bao Hiêm Vê Sưc Khoe (nêu co)

The Medical hay Bao hiêm Sưc khoe cua Tre

Giây Chưng Nhân Lam Viêc Toan Thơi Gian Danh cho chương trinh hoc (nguyên ngay tai trung tâm cho cac em Head Start hay

Âu Nhi Start)

Phu huynh Phai lam viêc 20+ giơ trơ lên tư Thư Hai – Thư Sau hay đi hoc toan thơi gian (it nhât 12 tin chi) đê đươc đu điêu kiên vao chương trinh lưa chon nay.

Xin Phu huynh vui long mang tât ca moi giây tơ cân thiêt đên môt trung tâmgân nhât cua OCHS hay Văn Phong Hanh Chanh. Chung tôi săn sang giup

Andrews HS**/EHS*** 1231 E Chapman

Fullerton, CA 92831 714-888-1201

Baden Powell HS*/**/EHS***

801 S. Gaymont St. Anaheim, CA 92804

714-236-4224

Buena Park HS*/** 6725 Dale St.

Buena Park, CA 90621 714-521-1909

Buena Park EHS***

6625 Dale St. Buena Park, CA 90621

714-367-1111

Capo HS* 31485 El Camino Real

San Juan Capistrano, CA 92675 949-661-8029

Carver HS *

11150 Santa Rosalia St. Stanton, CA 90680

714-598-6411

Centralia HS*/** 6627 La Cienega Dr.

Buena Park, CA 90620 714-228-9004

Crescent EHS***

5600 Crescent Ave. Buena Park, CA 90620

714-699-5930

Delhi HS*/** 505 E. Central Ave.

Santa Ana, CA 92707 714-361-8866

Doris L. Wood HS*

10871 Acacia Parkway Garden Grove, CA 92840

714-241-8920

E.L.V. HS**/EHS*** 32204 Del Obispo St.

San Juan Capistrano, CA 92675 949-661-5243

Franklin HS*/**/EHS***

506 South Janss St. Anaheim, CA 92805

714-399-2100

Fourth St. EHS*** 1626 E. 4th St.

Santa Ana, CA 92701 714-619-7900

Fullerton HS*/**

341 S. Courtney Ave. Fullerton, CA 92833

714-447-3005

Hope HS*/** 13841 Milton Ave.

Westminster, CA 92683 714-230-3832

Jeanne Hardy HS*/**/EHS***

17175 Emerald Ln. Huntington Beach,

CA 92647 714-842-1221

K.I.D.S. HS**/EHS***

1002 W. 2nd St. Santa Ana, CA 92703

714-541-8164

Lambert HS*/**/EHS*** 1060 W. Lambert Rd. La Habra, CA 90631

714-241-8920

Martin HS*/** 1008 W. Russell Ave. Santa Ana, CA 92707

714-427-1290

Matt Kline HS*/**/EHS*** 2043 Meyer Pl.

Costa Mesa, CA 92627 949-548-4480

Placentia HS*/**

840 S. Melrose St. Placentia, CA 92870

714-632-8787

Ruby Dr. EHS*** 601 Ruby Dr.

Placentia, CA 92870 714-854-8787

Schweitzer HS*/**/EHS***

211 S. Dale Ave. Anaheim, CA 92804

714-229-8790

Stanton HS*/** 8050 Chapman Ave. Stanton, CA 90680

714-230-3814

Topaz HS*/**/EHS*** 1600 Sapphire Rd. Fullerton, CA 92831

714-854-1534

Walter HS*/** 9200 Pacific Place

Anaheim, CA 92804 714-761-4967

OCHS Head Start and Early Head Start Home

Base Programs

* Part Day Program Available

** Full Day Program Available

*** Early Head Start Available