The following is an interest form for Little Giants Preschool. By filling out this form, you are giving us permission to contact you via email, phone, text, or mail about information related to your child and preschool.
Parent/Guardian
First Name (Required)
Middle Name
Last Name (Required)
Birthday (Required)
Gender
Female
Male
Email Address (Required)
Confirm Email Address
It appears that you have previously submitted an application. If you wish to apply again, please contact us by phone or in person.
Mobile Phone
Opt In for Text Messages
Yes
No
Home Phone
Work Phone
Ext.
It appears that you have previously submitted an application. If you wish to apply again, please contact us by phone or in person.
Race
American Indian or Alaska Native
Asian
Black or African American
Multi-racial/Biracial
Native Hawaiian/Other Pacific Islander
Other
Unspecified
White
Hispanic
Yes
No
Lives with Family
Yes
No
English Proficiency
Little
Moderate
None
Proficient
Other Language
American Sign Language
English
Spanish
Spanish
Swahili
Highest Grade Completed
Associate's Degree
Bachelor's Degree
College Degree/Training Cert.
College or Advance Training
General Education Diploma
Grade 10
Grade 11
Grade 12
Grade 9 or less
High School Graduate
Master's Degree
Employment Status
Full-time & Training
Full-time (35 hours/week or more)
Part-time & Training
Part-time (Under 35 hours/week)
Retired or Disabled
Seasonally Employed
Training or School
Unemployed
Child's Relationship
Biological/Adopted/Step
Foster
Grandchild
Other
Other Relative
Custody
Yes
No
Address
Is your family experiencing homelessness?
Yes
No
Living Address (Required)
Address Line 2
City (Required)
State (Required)
ZIP (Required)
Click here
to find a provider in your area.
Mailing Address same as Living Address
Mailing Address
Address Line 2
City
State
ZIP
Additional Parent/Guardian
Is there another parent/guardian in the family?
Yes
No
First Name (Required)
Middle Name
Last Name (Required)
Birthday (Required)
Gender
Female
Male
Email Address
Confirm Email Address
It appears that you have previously submitted an application. If you wish to apply again, please contact us by phone or in person.
Mobile Phone
Opt In for Text Messages
Yes
No
Home Phone
Work Phone
Ext.
It appears that you have previously submitted an application. If you wish to apply again, please contact us by phone or in person.
Race
American Indian or Alaska Native
Asian
Black or African American
Multi-racial/Biracial
Native Hawaiian/Other Pacific Islander
Other
Unspecified
White
Hispanic
Yes
No
Lives with Family
Yes
No
English Proficiency
Little
Moderate
None
Proficient
Other Language
American Sign Language
English
Spanish
Spanish
Swahili
Highest Grade Completed
Associate's Degree
Bachelor's Degree
College Degree/Training Cert.
College or Advance Training
General Education Diploma
Grade 10
Grade 11
Grade 12
Grade 9 or less
High School Graduate
Master's Degree
Employment Status
Full-time & Training
Full-time (35 hours/week or more)
Part-time & Training
Part-time (Under 35 hours/week)
Retired or Disabled
Seasonally Employed
Training or School
Unemployed
Child's Relationship
Biological/Adopted/Step
Foster
Grandchild
Other
Other Relative
Custody
Yes
No
Family Information
Number of Parents/Guardians
One Parent Family
Two Parent Family
Relationship to Participant(s)
Foster parent(s) not including relatives
Grandparent(s)
Other
Parent(s) (e.g. biological, adoptive, stepparents)
Relative(s) other than grandparents
Primary Language at Home
American Sign Language
English
Spanish
Spanish
Swahili
Is another language being acquired or learned at home?
Yes
No
Gross Annual Income
Is your family receiving cash benefits or other services under the Temporary Assistance for Needy Families (TANF) program?
Yes
No
Is your family receiving Supplemental Security Income (SSI)?
Yes
No
Is your family receiving services from WIC?
Yes
No
Is your family receiving services under the Supplemental Nutrition Assistance Program (SNAP), formerly referred to as Food Stamps?
Yes
No
Is at least one parent/guardian an active duty member of the United States military?
Yes
No
Is at least one parent/guardian a veteran of the United States military?
Yes
No
Emergency Contacts
Add Emergency Contact
Child (Applicant)
First Name (Required)
Middle Name
Last Name (Required)
Suffix
Nickname
Birthday (Required)
Gender
Female
Male
SSN
Race
American Indian or Alaska Native
Asian
Black or African American
Multi-racial/Biracial
Native Hawaiian/Other Pacific Islander
Other
Unspecified
White
Hispanic
Yes
No
English Proficiency
Little
Moderate
None
Proficient
Other Language
American Sign Language
English
Spanish
Spanish
Swahili
Primary Health Coverage
Children's Health Insurance Program (CHIP)
Combined Medicaid/CHIP
Medicaid
No Insurance
Other
Private Health Insurance
State-Only Funded Insurance
Insurance Number
Medicaid Number
Doctor/Medical Home
**Head Start
Acmira Brown
Alicia Reedy
Allergy and Asthma Center
Amanda Beach
Amanda Goins
Ann M. Webb
Ann Michelle Webb
April Gish
Arthroscopy & Ortopedic Surgery
Ball State Speech Therapy Clinic
Behavior Associates Of Indiana
Beth DeKoninck
Bridges to Health
Brittany Forum
Cami Barger-Jones
Cancer Services of Grant County
Caylor Nickel Clinic
Christopher Tallow
Community Partners Region 7
Community Pediatrics - Anderson
Community Pediatrics Anderson
Courtney Reeder
Cytrynowicz
Dawn Lagerkvist
Deb Hall
Deb Stiles
Debra Graber
Dr Byrne
Dr Yu
Dr. Abaitey
Dr. Adam Garner
Dr. Adam Will
Dr. Allen
Dr. Ally
Dr. Amanda Beach
Dr. Amanda Furr
Dr. Arun
Dr. Aswarf
Dr. Bahghat
Dr. Barger Jones
Dr. Bays
Dr. Becker
Dr. Bedford
Dr. Bertram
Dr. Bragg
Dr. Breckenridge
Dr. Brennan
Dr. Brown
Dr. Burtia
DR. CARLIE ELSTON
Dr. Castleman
Dr. Cetin
Dr. Chad Leighty
Dr. Cho
Dr. Chritman
Dr. Cickanova - ACC building
Dr. Conrad
Dr. Criswell
Dr. Cropper
Dr. Cytrynowicz
Dr. D. Broekhuizen
Dr. D. Edwards
Dr. D. Hougendobler
Dr. D.E. Neeley
Dr. DaKonick
Dr. Daniel Diedrich
Dr. David Sedaghda
Dr. Deb Hall
Dr. Debra Abaitey
Dr. Deepkaren Reddy
Dr. Dewalt - Anderson
Dr. Doris Jesch
Dr. Downs
Dr. E Ft. Wayne
Dr. E. Dale
Dr. Eley - Muncie
Dr. Elizabeth Pino
Dr. Elmasry
Dr. Emily Barrido
Dr. Eric Cox
Dr. Eric OBanion
Dr. Esther Fox
Dr. Ezeakudo
Dr. Fettig
Dr. Fisher
Dr. Fitts
Dr. Fouts
Dr. Frecker
Dr. Fuqua
dr. furr
Dr. G. Ashra
Dr. Gatewood
Dr. Geier
Dr. GiaQuinta
Dr. Gill
Dr. Gillum
Dr. Gohil
Dr. Grace Esan
Dr. Haganjoes
Dr. Helen Regal
Dr. Henry Martin
Dr. Hilbish
Dr. Holmes
Dr. Hougendobler
Dr. Hougendobler
dr. Hutchinson
Dr. Ike Ozoigbo
Dr. James Beitzel
Dr. Jared Miller
Dr. Jennifer Smith
Dr. Jesch
Dr. John Blake
Dr. Jones
Dr. Joseph
Dr. Joyce Fischer
Dr. Kahn
Dr. Kane - Noblesville
Dr. Karna
Dr. Karns
Dr. Katie
Dr. Keith Derrickson
Dr. Keller
Dr. Kendall
Dr. Kennedy
Dr. Kershner
Dr. Kimani
Dr. L Culver
Dr. L. Garner
Dr. L. Keenan
Dr. Lagervist
Dr. Layman
Dr. Lee
Dr. Links
Dr. Lora
Dr. Lourdu Savariar
Dr. Madgar
Dr. Mary Saleh
Dr. Matt Bruce
Dr. Melanie Zolman
Dr. Melissa Lora
Dr. Melvin Frecker
Dr. Michelle
Dr. Monica
Dr. Mugera
Dr. Niza
Dr. Novera Inan
Dr. Nunez
Dr. O'Banion
Dr. O'Brien
Dr. Oguntoye
Dr. Ogyonto
Dr. Paul Wolfe
Dr. Perry Muncie
Dr. Phillip Johnson
Dr. Pina
Dr. Pixley
Dr. R. Goldburg
Dr. R. Hutchison
Dr. Rajmaira
Dr. Rao
Dr. Reddy
Dr. Renfroe
Dr. Richard Evanseck
Dr. Richardson
Dr. Richey
Dr. Riegle
Dr. Rob Dawson
Dr. Roberts
Dr. Roger
Dr. Rose Turner
Dr. Rusk
Dr. S. Talker
Dr. Sackett Ft Wayne
Dr. Savariar - Huntington
Dr. Savariar - Parkview Peds
Dr. Sedaghat
Dr. Shannon Riegle - Upland
Dr. Sherif
Dr. Souchet
Dr. Speakman
Dr. Srishki
Dr. Srishti
Dr. Stage
Dr. Stalker
Dr. Steigmeyer
Dr. Steve Russo
Dr. Tallo
Dr. Templin
Dr. Teresa Mason
Dr. Triggs
Dr. Ulm
Dr. Unus
Dr. Utendorf
Dr. Vinson
Dr. W. Souchet
Dr. Waziri
Dr. Westfall
Dr. Westin
Dr. Whitt Peru
Dr. Wolfe
Dr. Woods
Dr. Wright
Dr. Yalamanchali
Dr. Yu
Dr. Zentz
Dr.H. Reigle
Draves Susan
Drook Medical Center
Dyton Children's Pediatrics
Ear, Nose, and Throat
EFNEP
Erin Vincen
Eskenazi Health
Family Medicine center
Family Service Society
Food Bags
Fort Wayne Pediatrics
Franciscan Health Network
Gas City Family Eye Care
General Pediatrics and Pediatric
Grant Co. Health Department
Healthy Horizons Pediatrics
Hearing Health Associates
Heart City Health Center Scenic
Heather Harrison
Houda Trabulsi
I.U. Medical Center.
In. Health Department
Indiana Health Center Kokomo
Indiana Health Centers, Inc
Irinck in Anderson
IUH ball memorial
J. Blake
James Hannis
Janelle Doctor
Jeanette Hoeksema, LCSW
Joyce Fiscler
Julie Utendorf
Kabuiya Mugera
Katheryn Anderson
Kathy Amburgey
Kathy Brinkman
Kavita Raj
Kelly Planck
Kids Plus Pediatrics
Kokomo Indiana Health Center
Kokomo Pediatrics
Kristi Mullenix
Kyle Speakman
Life Center Counseling Service
Linda Taylor
Local List of Dentists
Longe Vision Center
Lourdu S Savariar
Lutheran Hospital
M. Akisik
Madison County Community Health
Marcie Baird
Marion Family Dental
Marion Family Optometry
Marion Family Practice
Marion Fire Department
Marion Health
Marion Pediatrics
Mark O'Brien
Martin Center, Inc.
Mary Beth Hensley
MCS Special Services
Med Express
Melissa Lora
Mercy Family Health Center
Meridian Health Pediatrics
Michelle McDowell
Michelle Webb
Midwest Eye Consultant
Midwest Orthotics
Muncie Allergy Center
NEEDS!!
Nemours dupont Pediatrics
North Central Respiratory ,Inc.
Novera Inam
Oguntoye
Open Door Clinic
Orr, Mignon
Parkview Physicians Group
Patti Osborne
Pavillion Pediatric Center
Pediatrics Center
Prakash Karna
Preferred Eye Care
Pregnancy Help Center
Private Eye Vision
Pulaski Memorial Hospital
Rebecca's Hope
Regal, Helen
Riley Hospital for Children
Robert Dawson
Robert Zents
Robyn Culley
Samuel Kobba
Samuel Webb
Sandra Wright NP
School Based Behavior Consultati
Serenity Pediatric Services
Service Visual/Hearing Impaired
Steven Fitts
Sue Brown
Susan Draves
Susan Notingham
Susie Brown
Teresa Templin
Tobechukwu Coleman
Upland Health
Vocational Rehab
Wabash Medical Center
Wal-Mart Vision Center
Wendy Shannon
WIC
Wrap Around Access Site
Dental Coverage
Children's Health Insurance Program (CHIP)
Combined Medicaid/CHIP
Medicaid
No Insurance
Other
Private Health Insurance
State-Only Funded Insurance
Dentist/Dental Home
A Thomas
Adolescent and Pediatric Dentist
Alyssa William
Amy Butler
Anderson Pediatric Dentistry
Aspen Dental
Bruner Dental Center
Bunker Hill - Greentown
Catey Williams Dental
Charles McGee
Childrens Dentistry - Virginia
Clifford Sneed
Comfort Dental
Cool Smiles
Delaware Dental Solutions
Dentistry for Children of Ohio,
Downtown Dental
Dr. a. O'Null
Dr. Anderson
Dr. Beadle
Dr. Berry
Dr. Bouawden
Dr. Bowers
Dr. Brown
Dr. Brunner
Dr. Butterworth
Dr. Cascio
Dr. Catey Williams
Dr. Charles Barthalomew
Dr. Clifford Sneed
Dr. Courtner
Dr. Craig Wisler
Dr. Dehaven
Dr. Dryer
Dr. E. Juding
Dr. Erin Phillips
Dr. Evansack
Dr. Frecker
Dr. G. HInz
Dr. Hogland - Muncie
Dr. Hoover
Dr. Ireland
Dr. J. Steele
Dr. James Mercho
Dr. Jamie O'Lemna
Dr. Johnson
Dr. Joshi
Dr. Juding
Dr. Kelly
Dr. LaQuia Walker
Dr. Lehman
Dr. Leightty
Dr. Lemna
Dr. Lemna
Dr. Long
Dr. McClellan
Dr. Mercho
Dr. Musal
Dr. Musell in Muncie
Dr. Nicholson
Dr. O - Anderson
Dr. Pate
Dr. Pate
Dr. Phillip Catey
Dr. Poindexter
Dr. Raymond Maddox
Dr. Rector
Dr. Richard Evanseck
Dr. S. Kelly
Dr. Sajay
Dr. Segal
Dr. Sharp
Dr. Shupe
Dr. Simpson
Dr. Spencer
Dr. Steele
Dr. Steven Clute
Dr. Stuart Kelly
Dr. Taylor
Dr. Tinsley
Dr. Walker
Dr.S. Kelly
Familia Dental
Family & Cosmetic Dentistry
Fischers Pediatric Dentistry
Ft. Wayne
Great Lakes Family Dental
Gregory Johnson
Growing Greens Denistry
Hadley Family Dentistry
Hoosier Pediatric Dental Group
In Greenwood
Indiana Health Center Kokomo
Indiana Health Centers, Inc
J Satterfield-Siegel
J. Bouawden
J. Mercho
Jack Hoover
Jaime L Miller
Jewell Trumon
K & L Dental
Karen Sears
Kathryn Delacruz-Wright
Katie Williams
Kokomo Pediatric Dentistry
Kokomo Pedriatric Dentist
Kool Smiles
Ladd Dental Group
Lakewood Family Dental
Lifetime Smiles
Lindal Walker
Lisa Streeter
Little Heroes
Little Smiles
Litz Kids
Maple Creek Family Dentistry
Marion Family Dental
Markland Family Dental
Meridian
Midwest Family Dental Care
Mobile Dentist
Muncie Otolaryngology Associates
Muncie Pediatric
Myrna Janer
NEEDS!
Open Door Clinic
Pediatric Dental Specialist
Pediatric Dentistry of Noblesvil
Pippin Dental Fort Wayne
Progressive Dental
Rector Dental Group in Muncie
Riley Hospital for Children
Skyview Dental
Stuart Kelly
Tina Root
Weddell Pediatric Dentistry
Westend Dental
Youthful Smiles Children Dentist
Does your child have a disability or do you have any concerns about your child's development?
Yes
No
Is there anything else you want to tell us about your child?
Location Preferences
Which program are you applying for? (Required)
Little Giants Preschool 2024-2025
Location Preference
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1st Location Preference
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2nd Location Preference
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3rd Location Preference
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- Your Address
- Available Locations
Click a location on the map to see more info
Click here
to find a provider in your area.
Additional Applicant
Do you want to apply now for another child in your family?
Add Another Applicant
Siblings
Are there other children in the family?
Add a Sibling
You will receive an email confirmation once this interest form is submitted. However, your child's application is NOT complete. You must complete your child's application by attending one of our on-site registration events and providing us with all required documentation. The flyer with the on-site registration days/times/locations will be emailed to you.
Required information is missing, see above.