The following is the subsidy application for
Carla Martinez
. Click to approve, deny or request more information.

Proof of income

Enrollment details

Desired start date
01/30/2025
Schedule
Monday-Thursday
7:00 am - 3:30 pm

Documentation

Documentation of incapacitation
Proof of birth of child
Photo identification of child

Child information

Child name
Childs name
Gender
Female
Birthday
09/01/2022
Medical conditions
Asthma
Address
918 Waterfall Lane
City
Portland
State
OR
Zip Code
94109

Parent information

Parent name
Alex Kim
Email
AlexK@gmail.com
Phone
292-192-2929