PRIME TIME HEAD START Parent Interest Form
We are so happy that you are interested in applying for our NO COST pre-school program for 3 and 4 year olds in Ouachita Parish!
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Which school year are in interested in? *
What event did you attend, or how did you discover PRIME TIME HEAD START? (Event name or person's name) *
Child's LAST name *
Child's FIRST name *
Child's Date of Birth *
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Child's Gender *
Parent/Guardian LAST name *
Parent/Guardian FIRST name *
Parent/Guardian Date of Birth *
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DD
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YYYY
#1 Phone Number to reach Parent/Guardian (Include AREA CODE) *
#1 Phone- May we text you at this number? *
#2 Phone Number to reach Parent/Guardian (Include AREA CODE)
#2 Phone- May we text you at this number?
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Mailing Address/Street Address *
City *
Zip Code *
What is your #1 choice location to attend? *
What is your #2 choice location to attend? *
What is your #3 choice location to attend? *
What is your #4 choice location to attend? *
This is NOT an application, but this valuable information makes it possible for us to follow-up with you to start the application process!  THANK YOU SO MUCH!  Someone will be reaching out to you within 2 business days!
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