Intent to Enroll in CSISD Early Education
As we plan for the 2020-2021 School Year, we are gathering information on families who have an interest in applying for Early Head Start, Head Start, or Pre-K. Each program is an eligibility based program.

After completing this form, a staff member will contact you with information about completing an application.
Child's Legal Name *
First and Last
Your answer
Child's Date of Birth *
MM
/
DD
/
YYYY
Parent's Legal Name *
First and Last
Your answer
Parent's Primary Phone Number *
Your answer
Parent's Email Address *
Your answer
Address of where the child lives *
Your answer
What language does the child speak most of the time? *
Your answer
What Elementary Campus is your family zoned to? *
Please answer the following questions to the best of your ability. *
Yes
No
Is your family experiencing homelessness?
Is your family receiving public assistance? (SSI or TANF)
Is your family financially disadvantaged?
Is your child currently or has your child ever been in DFPS custody?
Is your child in foster care?
Is your child unable to speak and understand the English language?
Does your child have a parent/legal guardian who is an active duty member of the armed forces or has been injured/killed while serving?
Does your child have a parent/legal guardian who has ever been a recipient of the Star of Texas award?
Thank you for your interest in CSISD Early Childhood Education!
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