All High School / College / Vocational Students Participants are required to attend classes as scheduled.
Appointments for Medical, Dental, Mental Health, and Other Agencies/Providers.
Photo of Attendance / Class Schedule / Other Required Documents
Please send a clear photo that can be printed. If the photo can't be read when printed, we will request a different copy.
All income must be reported, earned or unearned, to determine continued eligibility. If you are uncertain what to report, please talk to the Case Manager. Participants who make fraudulent misrepresentations in order to obtain or continue to receive assistance will be denied further benefits until the overpayment is repaid and the case may be referred to the LEKT Prosecuting Attorney. By signing this document, I certify the information that I have provided is true and accurate and that I understand the above information. If I am not clear or have questions, I understand I can ask staff at any time.
I declare under penalty of perjury under the laws of the United States and the State of Washington that the facts contained in this report are true and correct and complete for the entire report month
You must sign this report or it will be considered incomplete.