Free Preschool Screening Form
Preschool Promise is a high-quality preschool model that is free to families that are 200% of the poverty guidelines and to children in foster care. Services are available in Coos Bay, North Bend, Myrtle Point, and Brookings.

The South Coast Regional Early Learning Hub is working with families to find programs that best meet their families needs, and with providers to ensure all programs have full enrollment.

All of the information in this form is confidential and identifying information will be shared only with applicable Preschool Promise Providers. ​
Should I complete this form?
If your answer is "no" to any of the following questions, and you are not completing this application for a foster child, you may not be eligible for publicly funded preschool. To learn more about Preschool Promise Eligibility contact us at or 541-435-7774.
1. Does your child turn 3 or 4 years old by September 1st 2021? *
2. Are you interested in Preschool Programs in the South Coast Region? (Coos, Curry and Coastal Douglas Counties) *
3. Is your family Income at or below 200% of the Federal Poverty Line (FPL)? *
(Household size is number of people supported by your family income)
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