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Get California Department Of Education Child Development Division Form Cd 9605

CALIFORNIA DEPARTMENT OF EDUCATION CHILD DEVELOPMENT DIVISION Form CD-9605 Revised 02/04 NOTE When applicable this form is to be completed and used with form CD-9600. TRAINING VERIFICATION PARENT OR CARETAKER ATTENDING SCHOOL OR RECEIVING TRAINING Please print or type information* DATE INSTRUCTIONS Determining eligibility for child development services requires that the parent or caretaker do the following 1. Complete all information requested* 3. Request that the registrar or his/her designee verify the training plan as described by signing and stamping this form* 2. When completed take this form to the school or organization where the training or education will be received* 4. Return this form within two weeks to the agency that will provide the child development services listed below. AGENCY Stanislaus County Office of Education/Child/Family Services/Alternative Payment Programs 1324 Celeste Drive Modesto CA 95355 209 238-6300 FAX 209 238-6499 PARENT OR CARETAKER S NAME last first middle TELEPHONE NO. STREET ADDRESS CITY ZIP CODE TRAINING/EDUCATION INFORMATION NAME OF SCHOOL OR ORGANIZATION WHERE TRAINING/EDUCATION IS RECEIVED DATE THIS TERM BEGAN ANTICIPATED COMPLETION DATE FOR TRAINING/EDUCATION PROFESSIONAL OR VOCATIONAL GOALS CLASS SCHEDULE if applicable DAY TIME ROOM NO. COURSE NAME UNITS SIGNATURE OF PARENT OR CARETAKER SIGNATURE AND STAMP OF REGISTRAR OF SCHOOL/ORGANIZATION. TRAINING VERIFICATION PARENT OR CARETAKER ATTENDING SCHOOL OR RECEIVING TRAINING Please print or type information* DATE INSTRUCTIONS Determining eligibility for child development services requires that the parent or caretaker do the following 1. Complete all information requested* 3. Request that the registrar or his/her designee verify the training plan as described by signing and stamping this form* 2. Complete all information requested* 3. Request that the registrar or his/her designee verify the training plan as described by signing and stamping this form* 2. When completed take this form to the school or organization where the training or education will be received* 4. When completed take this form to the school or organization where the training or education will be received* 4. Return this form within two weeks to the agency that will provide the child development services listed below. Return this form within two weeks to the agency that will provide the child development services listed below. AGENCY Stanislaus County Office of Education/Child/Family Services/Alternative Payment Programs 1324 Celeste Drive Modesto CA 95355 209 238-6300 FAX 209 238-6499 PARENT OR CARETAKER S NAME last first middle TELEPHONE NO. AGENCY Stanislaus County Office of Education/Child/Family Services/Alternative Payment Programs 1324 Celeste Drive Modesto CA 95355 209 238-6300 FAX 209 238-6499 PARENT OR CARETAKER S NAME last first middle TELEPHONE NO. STREET ADDRESS CITY ZIP CODE TRAINING/EDUCATION INFORMATION NAME OF SCHOOL OR ORGANIZATION WHERE TRAINING/EDUCATION IS RECEIVED DATE THIS TERM BEGAN ANTICIPATED COMPLETION DATE FOR TRAINING/EDUCATION PROFESSIONAL OR VOCATIONAL GOALS CLASS SCHEDULE if applicable DAY TIME ROOM NO.

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  • REGISTRAR
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