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Jackson Family

Jackson Family

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CM: Juan Lopez
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The following is the subsidy application for
Jackson Family
. Click to approve, deny or request more information.

Proof of income

September Paystub.docx
2024 W2 Document.pdf

Enrollment details

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

Documentation

Documentation of incapacitation
Dr.Ayers_Incapacitation.docx
Proof of birth of child
Childs_BirthCertificate.jpg
Photo identification of child
Childs_ID.pdf

Child information

Child name
Jessie Kim
Gender
Female
Birthday
03/03/2022
Medical conditions
Asthma
Address
918 Waterfall Lane
City
Portland
State
OR
Zip Code
94109

Parent information

Parent name
Baek-hyun Kim
Email
Phone
292-192-2929

Select Parent Preferences

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