Please complete each section, being sure to check for accuracy. If you have been awarded custody through the courts please check the custody box below, otherwise leave it blank. Please remember that Information entered incorrectly can delay the application review process.
Please list your current address below. Please be sure to notify our enrollment office should this information change prior to the start of the school year.
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Please complete each section with the secondary adult's information, being sure to check for accuracy. Information entered incorrectly can delay the application review process.
The objective of our Early Childhood program is to serve children and families that could benefit the most from our services. Answers to questions in the family information section assist us in determining eligibility. In the income section, please add income for the entire household. When completing the Emergency Contact information, please be sure to provide a contact number for each adult listed.
Please provide us with information about the child you are enrolling (name should be as printed on the birth certificate) and medical insurance information. If there is additional information such as dietary allergies, medical or behavior concerns please include it in the "Application Notes" section.
- Your Address - Available Locations
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Do you want to apply now for another child in your family?

Add Another Applicant

Are there other children in the family?

Add a Sibling
Required information is missing, see above.