CHILD'S INFORMATION
CHILD 1 (NOTE: this application is only for preschool-aged children, age 3 or 4 by Sept. 30, 2022) Please double check the birthdate.
Please upload a birth certificate or passport for child.
Attach
Please attach a copy of the IEP. (Please add at least one attachment) Attach CHILD 2 (NOTE: this application is only for preschool-aged children, age 3 or 4 by Sept. 30, 2022)
Please upload a birth certificate or passport for child. Attach Please attach a copy of the IEP. (Please add at least one attachment) Attach PARENT/GUARDIAN INFORMATION
ADULT 1: Birth Parent or Legal Guardian (must have custody papers) You will be contacted by a staff member of the Department of Early Learning as a next step in the application process; please be sure all the contact information is completed and accurate
State
Alabama
Alaska
Arizona
Arkansas
Armed Forces Asia
Armed Forces Europe
Armed Forces Pacific
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Please attach proof of address. (Lease, Mortgage, Utility Bill, or receipt of hotel) Attach Please attach Custody Papers. Attach Attach proof of employment, such as: most recent pay stubs, W2, LES, Income Tax Forms, or 1099.
Please attach a copy of all the above-checked documents as part of the application
Attach I certify that the above information is accurate. Inaccurate information can void my child's application and/or placement in the Norfolk Public Schools' preschool program. I have included all required documents so that proof of income can be considered complete and part of the application record. I understand that failure to attach the requested documents will result in this application NOT being processed.
ADULT 2: Birth Parent or Legal Guardian (must have custody papers). This adult must live at the same address as the child above.
Attach proof of employment, such as: most recent pay stubs, W2, LES, Income Tax Forms, or 1099.
Please attach a copy of all the above-checked documents as part of the application
Attach HOUSEHOLD INFORMATION
How many people are currently in your household including yourself and anyone under the age of 18?
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SCHOOL INFORMATION
The submission of this form to the Office of Early Learning/Title I indicates your desire for your child to be considered for enrollment in one of Norfolk Public Schools' preschool programs. By checking the Head Start box above, you authorize Norfolk Public Schools and Head Start/Office of Human Affairs to share the above information as part of the eligibility determination process. Your signature also indicates that the information provided is accurate to the best of your knowledge. Applications received without the proper supporting documents will not be processed. Acceptance into preschool is NOT first come, first serve; rather, it is determined by program eligibility requirements.