Get DD 2606 1998

PLACEMENT TIME In months DD FORM 2606 JUL 1998 PREVIOUS EDITION MAY BE USED. Adobe Professional 8. 0DEPARTMENT OF DEFENSE CHILD DEVELOPMENT PROGRAM REQUEST FOR CARE RECORD AUTHORITY PL 101-89 Sec* 1507 EO 9397. PRIVACY ACT STATEMENT ROUTINE USE S None. PRINCIPAL PURPOSE S To collect applicant information for Child Development Programs and place applicants on waiting lists for program services. Information compiled from applications is also used to assist management determination of effectiveness of present and projection of future program requirements. 1. DATE OF REQUEST YYYYMMDD DISCLOSURE Voluntary however failure to furnish requested information will result in an incomplete request for care record and possible loss of placement on Child Development Program waiting lists. 2. EXPIRATION DATE YYYYMMDD 3. FAMILY INFORMATION a* SPONSOR S NAME Last First Middle Initial b. SPOUSE S NAME Last First Middle Initial c* CHILD S NAME Last First Middle Initial d. CHILD S DATE OF BIRTH YYYYMMDD f* HOME ADDRESS Street City State Zip Code g. SPONSOR S BRANCH OF SERVICE e. CHILD S AGE h. DUTY ORGANIZATION i. HOME TELEPHONE NUMBER Include Area Code j. DUTY TELEPHONE NUMBER Include Area Code k. SIBLING CARE Complete a separate form and list name and date of birth for each child requiring care 2 DATE OF BIRTH YYYYMMDD 1 NAME Last First Middle Initial 5. AGE GROUP X one 4. PROGRAM S DESIRED X as applicable a* FULL-DAY CARE e. FAMILY DAY CARE FDC a* INFANTS 0 - 12 months b. PART-DAY CARE f* PART-DAY ENRICHMENT b. TODDLERS 13 - 35 months c* SCHOOL-AGE g. DAY CAMP c* PRESCHOOL 3 - 5 years d. SPECIAL NEEDS d. SCHOOL AGE 5 years 6. SPONSOR STATUS X one a* SINGLE MILITARY e. SINGLE DOD CIVILIAN i. MILITARY/UNEMPLOYED SPOUSE b. DUAL MILITARY f* RETIRED MILITARY j. MILITARY/OTHER THAN DOD SPOUSE c* MILITARY/DOD SPOUSE g. MILITARY RESERVE k. OTHER Specify d. DUAL DOD CIVILIANS h. NATIONAL GUARD 7. PRESENT CHILD CARE ARRANGEMENTS X as applicable a* FDC ON-INSTALLATION d. CIVILIAN CDC g. IN-HOME CARE b. FDC OFF-INSTALLATION e. MILITARY ALTERNATE CARE h. NO PRESENT CARE c* OTHER MILITARY CHILD f* NON-MILITARY ALTERNATE DEVELOPMENT CENTER CDC CARE 8. GENERAL INFORMATION X and complete as applicable YES NO a* IF CHILD IS NOT PRESENTLY IN CARE IS EMPLOYMENT OF SPOUSE AWAITED If Yes estimate average annual income lost b. HAS CHILD BEEN IDENTIFIED FOR SPECIAL NEEDS d. CURRENT COST OF CARE PER WEEK If child is currently in care c* IS CHILD ON OTHER MILITARY WAITING LIST If Yes name installation 9. UPDATE REQUIRED PER INSTRUCTIONS For Office Use Only a* DATE CALLED b. DECLINED/ PLACED c* COMMENTS/ INITIALS d. DEPARTMENT OF DEFENSE CHILD DEVELOPMENT PROGRAM REQUEST FOR CARE RECORD AUTHORITY PL 101-89 Sec* 1507 EO 9397. PRIVACY ACT STATEMENT ROUTINE USE S None. PRINCIPAL PURPOSE S To collect applicant information for Child Development Programs and place applicants on waiting lists for program services. PRIVACY ACT STATEMENT ROUTINE USE S None. PRINCIPAL PURPOSE S To collect applicant information for Child Development Programs and place applicants on waiting lists for program services. Information compiled from applications is also used to assist management determination of effectiveness of present and projection of future program requirements. .