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White County Schools PRE-K Income Eligibility
Completion of this form DOES NOT qualify your child for the Free or Reduced Meal Program.
Submission of this application is not a guarantee of acceptance into the VPK program.
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Email
*
Your email
Name of Applicant:
*
Your answer
Date of Application:
*
MM
/
DD
/
YYYY
Name of Student:
*
Your answer
SSN of Student (optional)
Your answer
Student's Date of Birth
*
MM
/
DD
/
YYYY
Applicants relationship to student:
*
Choose
Mother
Father
Legal Guardian
Foster Parent
Mailing Address
*
Your answer
City
*
Your answer
State
*
Your answer
Zip Code
*
Your answer
Home Phone Number
*
Please include area code.
Your answer
Work Phone Number:
*
Please include area code.
Your answer
Cell Phone Number
*
Please include area code.
Your answer
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