Tazewell / Woodford Head Start Program

ABOUT HEAD START

RESOURCES

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Enrollment/Contact Form
Please fill out the following form if you would like to be contacted by Head Start for an application appointment for your child. You will then be directed to a page listing the items you must bring with you to your appointment.

Please provide us the following contact information
Parent/Guardian Name:
Address:
City:
State:		Zip Code:
Home Phone:	Area - Phone
	-
Cell Phone:	Area - Phone
	-
Email:

Please provide your child's information
Child's Name:
Date of Birth: (example: 20041223)

Do you have any concerns about your child?:

ABOUT HEAD START

RESOURCES

Enrollment/Contact Form

Please fill out the following form if you would like to be contacted by Head Start for an application appointment for your child. You will then be directed to a page listing the items you must bring with you to your appointment.

Please provide us the following contact information

Please provide your child's information

Please fill out the following form if you would like to be contacted by Head Start for an application appointment for your child.

You will then be directed to a page listing the items you must bring with you to your appointment.