2. Complete application in its entirety and sign.
3. Bring completed and signed application to HCPC with the following required documents:
- Child's Birth Certificate
- Proof of Regular Gross Income (two recent pay stubs, if unemployed, please submit a notarized statement regarding your unemployment).
- Proof of County Residency (Lease or Rental agreement, copy of utility bill showing address.)
- Updated Vaccination Record
- Health Assessment
- Proof of Active Duty Military Status (Military ONLY, current LES)
For more information, please contact Tara Fish, Program Manager, at (910) 893-2344.