Quick Tips for Filling Out VPK Certificate of Eligibility (COE)

VPK Program

How to complete VPK COEs – Rev. 5/09/18ig Page 1 of 2

Section I: Generated by OEL Provider Portal

• Box 1 - VPK program year: Verify that the program year is for the current VPK session.• Box 3 - Certificate issue date: Enter the date the certificate was issued and the beginning of

eligibility• Box 8 - Child’s full name: Ensure that you enter the child’s name the exact way it was submitted,

per proof of age, with application.

Please DO NOT WRITE in boxes 1–10. Any change or alteration made will result in an invalid Certificate. If a parent would like to make changes, they will need to contact the Early Learning Coalition of Hillsborough County (ELCHC).

Section II: To be completed by the provider & parent

• Box 11-13 - Write the name of the child care provider, telephone number and address of the VPKprogram site.

• Box 14 - Write the CLASS ID legibly• Box 15 - Write the date the child will be attending in MM/DD/YY form. This date CANNOT be prior

to the certificate issue date in Section 1 Box 3.• Box 16 & 17 - Provider signature and date• Box 18 & 19 - Parent signature and date

* If you need to make a correction, please mark a line through the error, write the correct information andwrite your initials next to the correction (see example in Section II Box 15 below).

Section III: Generated by OEL Provider Portal

This section should have the Early Learning Coalition contact information for payment. When accepting VPK certificates, verify that the Coalition to contact is “ELC of Hillsborough”; otherwise, you will not be paid. If the Coalition to contact for payment listed on the Certificate is not the ELC of Hillsborough County, please advise the parent to contact the Early Learning Coalition listed in this section to request a VPK certificate transfer to Hillsborough County.

PLEASE NOTE: After your VPK program begins and you receive a VPK Certificate from a parent, ask the parent or the ELCHC if the Certificate has already been used by another provider. ELCHC will only pay the first provider with whom the child attended VPK. The original Certificate is only valid to use with one provider. To transfer a child to a different VPK program/provider, a Reenrollment Certificate is required prior to attending.

STATE OF FLORIDA VOLUNTARY PREKINDERGARTEN (VPK) EDUCATION PROGRAM

Child Certificate of Eligibility

Form OEL-VPK 02 (February 2017)

Rule 6M-8.201, F.A.C.

I. CHILD CERTIFICATE OF ELIGIBILITY (Issued by Early Learning Coalition, through the Family Portal)1. VPK program year 2. Certificate number 3. Certificate issue date 4. Parent email address

5. Parent name 6. Primary contact number 7. Secondary contact number

8. Child’s full name 9. Child’s date of birth 10. County

II. ADMISSION BY PROVIDER OR SCHOOL (Jointly Prepared by Provider or School AND Parent or Guardian)

11. Name of provider or school 12. Telephone

13. Address of VPK site 14. VPK class 15. Date child will begin

attendance

The provider or school certifies that it admits the child

(item 8) for enrollment in the VPK program and agrees to

deliver the program for the child.

I certify that I choose the provider or school (item 11) to

deliver the VPK program for my child and direct that

program funds be paid to the provider or school for my

child.

16. Signature of authorized representative for

provider or school

17. Date 18. Parent signature 19. Date

III. ENROLLMENT SUBMISSION AND CONFIRMATION (Submitted by Provider or School)

TO PROVIDER OR SCHOOL:

Contact the coalition upon enrollment of the child for payment. The Early Learning Coalition may issue a confirmation number for payment (below).

TO CONTACT THE COALITION FOR PAYMENT:

IS YOUR CONFIRMATION NUMBER (IF APPLICABLE)

NOTICE TO PRIVATE PROVIDER OR PUBLIC SCHOOL: A private provider or public school must keep each original signed form for at least 5

years. A private provider must permit the early learning coalition, and a public school must permit the school district, to inspect the original

signed forms during normal business hours. If required by the early learning coalition, a signed copy of this certificate must be

forwarded to the coalition or a qualified contractor acting on behalf of the coalition.

2018-2019 VPK1040580-2018 8/11/2018 johnsmith@elc.com

John Smith

Jane Smith 02/09/2014 Hillsborough

ELC of Hillsborough(813) 515-2340http://www.elchc.org/

8/10/2018

(813)111-1111

ELC Academy (813)222-2222

6800 N. Dale Mabry Suite 150, Tampa, FL 33614 A

Susan Day John Smith8/11/2018 8/11/2018

(813)333-3333

How to complete VPK COEs – Rev. 5/09/18ig Page 2 of 2