Danville Head Start Pre-K  Pre-Application Form (Location- Pennsylvania) 
Please fill out this Pre-Application and a Family Advocate  will contact you about eligibility and enrollment.
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Child's Name: *
Child's Date of Birth *
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Male or Female
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Primary Parent/Guardian Name: *
Secondary Parent/Guardian Name:
How many people are in your family? *
What is your estimated yearly family income? *
Child's Address: *
Phone number to reach you: *
Email Address:
How did you hear about Head Start? *
Name of individual filling this form out: *
Today's Date: *
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