Regence Caring Foundation for Children

Application Downloads

If you are interested in enrolling your child in our program, please download one of the applications below. Income guidelines and other important information are included this document.

• Please print out and complete one application per family (multiple children from one family may be listed on a single application).
• Include the income verification requested. Without this we cannot process your application.
• Once you've completed the form, sign and date the second page, and mail the application and income verification to the address listed on the form.

Download the Application in English (PDF).

Download the Application in Spanish (PDF).

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