NOTE: This application is for CHILDREN 6-17 needing placement. If you are a single mother with children needing family care assistance, please use this form instead: http://bit.ly/OBHC-FamilyApp. Thank you.
By checking your placement location preference below we will know how to best direct your application.
Legal Custody/Guardian InformationWho has legal custody of the child?
Please note - information in this section and from here on is about the child - not the person filling out the application. Thank you!
As a courtesy, we would like to notify you of the initial status of your application. This is optional and is just our way of keeping you informed of the process. Once the campus reviews your application, they will be contacting you. If you would like us to let you know of the initial status of processing, please indicate your preference.