Thank you for your interest in our program. Rural Utah Child Development provides services to pregnant mothers and children ages 0-5. This application is for first-time applicants ONLY. If you have applied previously or if you wish to submit a prenatal application, please return to our website at www.rucd.org and click on the appropriate link. You may also call Lauren Aquilino at 435.630.8451 for assistance.
Parent/Guardian
This section is for information about the applying child's parent. If the parent is not in the home, then information should be completed for the person who has legal guardianship or is currently caring for the child.
First Name (Required)
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.
English Proficiency
Little
Moderate
None
Proficient
Other Language
African Languages
American Sign Language
Asian
Brazilian
East Asian Languages
English
Italian
Japanese
Native American Language
Native Central/South American & Mexican
Native North American/Alaska Native Lang
Navajo
Pacific Island Languages
SIGN
Spanish
Other Language Proficiency
Little
Moderate
None
Proficient
Child's Relationship
Biological/Adopted/Step
Foster
Grandchild
Other
Other Relative
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 household? For the purpose of this application, only list adults living in the home if they are related to the applying child through blood, marriage, or adoption.
Is there another parent/guardian in the family?
Yes
No
First Name (Required)
Last Name (Required)
Birthday (Required)
Gender
Female
Male
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.
English Proficiency
Little
Moderate
None
Proficient
Other Language
African Languages
American Sign Language
Asian
Brazilian
East Asian Languages
English
Italian
Japanese
Native American Language
Native Central/South American & Mexican
Native North American/Alaska Native Lang
Navajo
Pacific Island Languages
SIGN
Spanish
Other Language Proficiency
Little
Moderate
None
Proficient
Child's Relationship
Biological/Adopted/Step
Foster
Grandchild
Other
Other Relative
Child (Applicant)
First Name (Required)
Last Name (Required)
Birthday (Required)
Gender
Female
Male
Location Preferences
Which program are you applying for? (Required)
Head Start 2023-2024 School Year
Free Preschool for Children Ages 3-5
Early Head Start
Free High-Quality Home-Based Education for Infants, Toddlers, and Their Parents
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. A staff member will contact you to ask a few questions to help us better understand the needs of your child and family. You will also be asked to submit a record of birth as well as income verification for the last twelve months or previous calendar year to complete the application process. Once your documentation is verified, your child will be placed on a waiting list. We will notify you as soon as there is an opening for your child. By clicking "Submit", I certify that this information is true. If any part is false, my participation in this agency’s program may be terminated. I also understand that the information in this application will be held in strict confidence within the agency and is accessible to me during normal business hours.
Required information is missing, see above.