Thank you for your interest in our Child Care/Preschool programs! Please answer all questions on this form to the best of your knowledge in order to start the application process. Once received, a staff member will contact you to complete your application. If you have previously applied to our program, please DO NOT fill out a new application. Instead, please call Holly at 207-680-7211 for Educare applications, or Jackie at 207-859-1599 for all other locations.
Parent/Guardian
First Name (Required)
Last Name (Required)
Birthday (Required)
Gender
Female
Male
Non Binary
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
African Languages
American Sign Language
Arabic
Bengali
Chinese
English
Far Eastern Asian Languages
French
Korean
Native American Languages
Persian (Farsi)
Spanish
Other Language Proficiency
Little
Moderate
None
Proficient
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
Family Information
Please complete all information to the best of your knowledge
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
African Languages
American Sign Language
Arabic
Bengali
Chinese
English
Far Eastern Asian Languages
French
Korean
Native American Languages
Persian (Farsi)
Spanish
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
Is your family receiving services under the Supplemental Nutrition Assistance Program (SNAP), formerly referred to as Food Stamps?
Yes
No
Child (Applicant)
Please provide us with a little information about the child you would like to enroll in our program
First Name (Required)
Last Name (Required)
Birthday (Required)
Gender
Female
Male
Non Binary
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
Other Language
African Languages
American Sign Language
Arabic
Bengali
Chinese
English
Far Eastern Asian Languages
French
Korean
Native American Languages
Persian (Farsi)
Spanish
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)
Online Preschool 2023-2024
Online Infant/Toddler Childcare 2023-2024
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
By submitting this online application, I indicate that I understand and agree with the following statements: *The information is correct to the best of my knowledge. *Information will be stored in a secured electronic record system by KVCAP. *KVCAP will assure privacy and confidentiality per agency policies and relevant laws. *KVCAP may access my information to: determine program eligibility; support service delivery; show compliance with funder requirements. *Personal information will be de-identified (no names) unless required for the specific program(s) I choose to participate in. *Additional information may be required to determine eligibility for specific KVCAP programs.
Required information is missing, see above.