Welcome to the 2023-2024 Chesterfield County Public Schools PreK Application. Students must be 4 years old by September 30, 2023 in order to be considered. This is the first step in the application process so please answer all questions as accurately as possible. At the end of this application, you will be asked to upload the child's birth certificate and your income documentation. We are unable to proceed further until we receive this information. You will receive an email link to upload documents and we ask that you check your email regularly for correspondence from our office. If you do not have access to upload your documents electronically, we will make arrangements for you to hand-deliver your documents. In order to process the application, you must provide information for all questions asked. Not answering all questions could cause a delay in determining the family's status for the program. Please note that this is NOT a first come, first served process, and you must meet eligibility requirement to be considered for the program. All complete applications will be processed for eligibility. If you would like more information on early care and education providers in your area, please visit https://www.dss.virginia.gov/cc/index.html where you can search for more information within the county.
Parent/Guardian
Only parents and legal guardians may apply for publicly funded PreK programs.
First Name (Required)
Last Name (Required)
Suffix
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
English Proficiency
Little
Moderate
None
Proficient
Other Language
American Sign Language
Arabic
Burmese
Cambodian
Cantonese
English
French
Mandarin
Other
Portugese
Spanish
Vietnamese
Other Language Proficiency
Little
Moderate
None
Proficient
Highest Grade Completed
6th-8th grade
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
K-5th grade
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
Lives with Family
Yes
No
Provides Financial Support
Yes
No
Teen Parent
Yes
No
If Teen Parent, Subsidized?
Yes
No
Address
Please complete this section using the address where you currently reside.
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.
Additional Parent/Guardian
The Secondary Adult must live with and/or have custody of the student.
Is there another parent/guardian in the family?
Yes
No
First Name (Required)
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
English Proficiency
Little
Moderate
None
Proficient
Other Language
American Sign Language
Arabic
Burmese
Cambodian
Cantonese
English
French
Mandarin
Other
Portugese
Spanish
Vietnamese
Other Language Proficiency
Little
Moderate
None
Proficient
Highest Grade Completed
6th-8th grade
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
K-5th grade
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
Lives with Family
Yes
No
Provides Financial Support
Yes
No
Teen Parent
Yes
No
Family Information
Please complete ALL of the questions in this section to assist in the application process.
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
Arabic
Burmese
Cambodian
Cantonese
English
French
Mandarin
Other
Portugese
Spanish
Vietnamese
Is another language being acquired or learned at home?
Yes
No
Number in Household
Number in Family
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
WIC ID (if applicable)
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)
Please complete all of the questions in this section. This information is about your PreK aged child.
First Name (Required)
Middle Name
Last Name (Required)
Suffix
Nickname
Birthday (Required)
Gender
Female
Male
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
Arabic
Burmese
Cambodian
Cantonese
English
French
Mandarin
Other
Portugese
Spanish
Vietnamese
Other Language Proficiency
Little
Moderate
None
Proficient
Primary Health Coverage
Children's Health Insurance Program (CHIP)
Combined Medicaid/CHIP
Medicaid
No Insurance
Other
Private Health Insurance
State-Only Funded Insurance
Other Coverage
Children's Health Insurance Program (CHIP)
Combined Medicaid/CHIP
Medicaid
No Insurance
Other
Private Health Insurance
State-Only Funded Insurance
Insurance Number
Medicaid Eligibility
Not Eligible
On Medicaid
Potentially Eligible
Medicaid Number
Doctor/Medical Home
Adolescent & Pediatric Health P
Bon Secour Care-A-Van
Bon Secour Family Practice
Bon Secour Laburnum Medical CTR
Bon Secour Pediatrics Richmond
Bon Seocur Pediatrics Of Mechan.
Brandermill Ped/Adolescent
Briggs Rd Family Medicine
Caldwell Pediatrics and Wellness
Capitol Pediatrics
Care A Van
Chester Pediatrics
Chesterfield Dept of Health
Chesterfield Family Practice CTR
Chesterfield Pediatrics
Children & Adolescents Clinic
Children's Clinic/ Frederickburg
Children's Hospital of Richmond
Chippenham Pediatric and Adolesc
Colonial Heights Pediatrics
Commonwealth Pediatrics
Crossbridge Pediatrics and Inter
Crossover Ministry
CVS Pharmacy/Minute Clinic
Daily Planet Health Services
Dr A Rose
Dr A Tuohy
Dr C Goodall- Vernon J Harris MC
Dr C. Boone
Dr Charuwan Siri
Dr J Mason
Dr K Bowers
Dr K Tilghman
Dr Meyer and Lovings
Dr Philip Valmores
Dr. Carolyn Boone
Dr. Lori Mitchell
Dr. Sandra Bell
Dr. V Licen
Drs Richard Or Lillie Bennette
Drs. Mayes And Lovings
Happy Kidz Pediatrics
Hayes E Willis Cliniw
Henrico Pediatrics
Huguenot Pediatrics
Infant Jesus Children's Clinic
Ironbridge Family Practice
James River Pediatrics
Kenner Army Health Clinic
Little Clinic of VA
Manchester Pediatric Assoc
Monuement Ave Pediatrics
Newport News Pediatrics
Northside Medical Clinic
Old Dominion Pediatrics
Patient First
Patterson Ave Family Practice
Pediatric Associates
Pediatric Associates
Pediatric Center- Laburnum
Pediatric Grp Practice Children
Pediatric Partnership
Pediatric Practice- Children's P
Pediatric Primary Care
Pediatric&Adolescent Medicine
Pediatrics of Richmond
Peds First Healthcare
Powhatan Medicine Assoc
Primary Health Group
Prime Care Family Practice
Richond Pediatrics Assoc
Riverbend Enon Pediatrics
RVA Pediatrics
Sentara Pediatrics Physicians
South HIll Family Medicine
Southside Pediatric Center
St Francis Family Medicine
Swift Creek Pediatrics
The Little clinic
VCU Hayes E Willis Health Center
Vernon J Harris community Health
Virginia Eye Institure
Virginia Pediatrics PC
Wilkerson Clinic
Yu Pediatrics
Dental Coverage
Children's Health Insurance Program (CHIP)
Combined Medicaid/CHIP
Medicaid
No Insurance
Other
Private Health Insurance
State-Only Funded Insurance
Dental Coverage Number
Dentist/Dental Home
Bitty Bites Pediatric Dentistry
Bon Secour Pediatric Dental
Cardinal Pediatric Dentistry
Children's Dentistry of VA
Children's Hosp Of Richmond
Colliseum Ped Dentistry
Commonwealth Pediatric Dental Sp
D &D Dentistry
Dentistry fo Children
Dr A Al Najjar
Dr Brandon ALLen
Dr Brian Burke
Dr G Verkey
Dr Jarvandi
Dr R. Byrd And Associates
Dr Sandra J Smith Family Dentist
Dr Sury Bhavaraju
Dr. Martin Oakes
Dr. Michael Davis
Dr. Sandra Smith
Dt T. Schleicher
Family Dentistry of Short Pump
Happy Smiles
Haselman & Hunt Family Dentistry
Heavenly Hands
Hopewell Family Dentistry
Ideal Debtal Care
Just 4 Kids
Kool Smiles
Lutz Medicine
Midlothian Children's Dentistry
Murry and Kuhn Dentistry
Pediatric Dentistry&Orthodontic
RA Dentla Care PLLC
Randazoo Dentistry
Richmond Pediatric Dentistry& Or
Richmond Smiles Center
Robious Crossing Ped Dent
RVA Children's Dentistry
RVA Pediatric Dentistry
Smile 32
South River Dentistry
Southside Dental
Southside Smiles Dentistry
Sparkle Dentistry
Spencer Dental & Braces
ToothBeary Peds
Tuckahoe Family Dentisry
United Smiles
VCU Dental Care Children's Pav
VCU Pediatric Dentistry
Virginia Family Dentistry
Wood, Lombardozzi, Dunlevy
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)
Applications 23/24
1st Location Preference
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2nd 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
Thank you for taking the time to apply to the Chesterfield County Public Schools PreK Program and completing the first step of the application process. By clicking the button below, you are certifying that the information you provided is complete and accurate. Again, your application will not be processed or considered until you have uploaded all household income documentation (including SNAP, SSI, SSA, and TANF). and the birth certificate. The PreK Office will contact you via telephone or email to set up the next step in the application process.
Required information is missing, see above.