AMA Great Start Readiness Program Pre-Application
Children must be 4 years old on or before September 1st and fully toilet trained
Free Preschool for 4 year olds meeting program eligibility guidelines.
Date of Application *
Child's Last Name *
Child's First Name *
Child's Gender *
Child's Date of Birth *
With whom does the child reside? *
Child's Home Address *
City *
State *
Zip Code *
Mother's Name
Mother's Address
Mother's Phone # *
Mother's Marital Status
Father's Name
Father's Address
Father's Phone Number *
Father's Marital Status
Total number of people living in the household *
Total number of people working *
Estimate of Income in the household (please specify if weekly, biweekly, monthly or annually) *
Are there any other factors that you think may qualify you for the GSRP program? *
Family Email Address *
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