Thank you for your interest in our regional Childcare and Preschool Programs, including; Botetourt, Craig, Franklin, and Roanoke Counties; and the Cities of Roanoke and Salem. This application will help to match you with programs that you may be eligible for, as well as those that meet the individual needs of your family. Information collected can assist in determining your family’s eligibility for the following programs: Head Start, Virginia Preschool Initiative, Private Childcare, Family Day Home Provider, or additional state and federal assistance. In order to effectively process your application, you must provide information for all questions asked. Not answering all questions, or not providing required documentation, could cause a delay in determining your family’s status. Once your application has been processed and reviewed, your family will be contacted with information regarding next steps for you to take. Should you be placed on the waitlist for your program of preference, an alternative program will be provided to you in the form of a referral. You will be redirected to documentation uploads, eligibility questions, and location preferences when you submit this application.

Parent/Guardian

Please complete the following information about the parent/guardian(s) of the child applicant.

Address

Click here to find a provider in your area.

Additional Parent/Guardian

Please, only include adults that are legally considered parent/guardian to the child applicant. This can be through biological relationship, marriage, or adoption. Any other adults contributing to the household may be added in "Other Adults". Appropriate paperwork such as custody papers shall be attached if parent is not allowed to pick up the child. *NOTE: Section 22.1-4.3 of the code of Virginia states that unless a court order has been issued to the contrary, the noncustodial parent of a student enrolled in a public school or day care center must be included, upon , as an emergency contact for events occurring during school or day care activities.

Other Adults

Are there other adults in the household?

Add Another Adult

Family Information

The following section is required to be completed in it's entirety if you would like to enroll your child in a free or reduced early education program or childcare center. Documentation is required to verify the following information. If your child is in foster care or homeless, and you are ONLY applying for Head Start, you may skip this section.

Emergency Contacts

Child (Applicant)

Please complete the following information about your child.

Location Preferences
- 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
Once you submit, you will be redirected to the second portion of the application. This part of the application will allow you to choose location preferences, upload required documentation, and answer questions to determine eligibility. Thank you for taking the time to fill out our online application. We look forward to reviewing your information, and getting back to you soon.
Required information is missing, see above.