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ECE002 (formerly known as CS186D2) REV. 6/15Referral for Early Care and Education Services (This is not a voucher) 1. CASE IDENTIFICATION ACS Case Number:ACS Case Name:CNN ID Number:Stage ID Number:Date.

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How to fill out the NY ECE-002 online

The NY ECE-002 form, also known as the referral for early care and education services, is vital for facilitating access to early care and education resources. This guide will provide you with step-by-step instructions to successfully fill out the form online, ensuring accurate submission and compliance with requirements.

Follow the steps to effectively complete the NY ECE-002 form online.

  1. Click the ‘Get Form’ button to access the NY ECE-002 form. This will open the form in your preferred online editor where you can begin filling it out.
  2. In the first section, labeled ‘CASE IDENTIFICATION’, provide the ACS case number, name, CNNX ID number, stage ID number, and the date of referral. Ensure that all details are accurate to prevent processing delays.
  3. Proceed to the ‘TYPE OF REFERRAL’ section. Select one of the three options to categorize the referral as Foster Care, Preventive, or Child Protective. This classification is essential for the review process.
  4. Fill in the ‘REFERRAL SOURCE INFORMATION’. Enter the referral source’s name, phone number, email, and fax. Also, include the name of the supervisor and their respective contact details, along with the agency and program name.
  5. Next, complete the ‘FAMILY/CARETAKER INFORMATION’ section. This includes the caregiver's name, title (select from parent, foster parent, or other), household structure (single or two-parent), primary language, and multiple contact numbers.
  6. Continue to the ‘CHILDREN NEEDING EARLY CARE AND EDUCATION SERVICES’ section. You will input details for up to four children, including their names, gender, special needs (if any), birth dates, primary language, eligibility code, and preferences regarding borough.
  7. In the ‘HOUSEHOLD INFORMATION’ section, list all members of the household, their relationship to the caretaker, and their personal data including race, date of birth, and gender.
  8. Complete the ‘EMPLOYMENT’ section by filling in the parent’s/caretaker’s employer information alongside their scheduled hours and any relevant details about their job.
  9. If necessary, provide documentation of the caretaker’s work status and income in the ‘INFORMATION USED TO DOCUMENT CARETAKER’S WORK STATUS AND/OR INCOME’ section. Depending on the case eligibility, this section may not apply.
  10. Finalize the form by ensuring the ‘CERTIFICATION’ section is completed appropriately, including necessary signatures. Once finished, make sure to save your changes, and you may print, download, or share the form as required.

Complete your NY ECE-002 form online today to ensure timely processing of early care and education services.

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