Pre-Registration Form

                    

Are you looking for free high quality preschool for a child who is 3 to 5 years old and wondering if you qualify? Please fill out our Pre-Registration Form to determine if your child is eligible to attend a free Great Start Readiness Program (GSRP) or Head Start preschool program in Holly. Any family wishing to apply for GSRP or Head Start needs to complete this pre-registration form to begin the process. Upon completion, someone will contact you to further discuss program options. If you have further questions, please contact us at 248.328.3027.
Child's Information
mm/dd/yyyy
Gender:
Parent/Guardian Information
Marital Status:
Child lives with: (check all that apply)
Help for Names and ages of children in household/school each child attends: Please include the names and ages of all children in the household.
Household Income
Verification of Income will be required.
Income Source:
Additional Information
Is there any additional Information that you can share about your child/family? (check all that apply)
Is child Potty Trained?
How did you learn about us?
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