Morgan County Universal Pre-K Interest Form

Morgan County Universal Pre-K Interest Form
IMPORTANT INFORMATION, PLEASE READ:

Completing this form does NOT register your child for pre-k. It will send your completed form to the Morgan County Head Start/Pre-K Family Advocates who will contact you to schedule an appointment to register your child.

Please take note of the following items that you will need to gather and bring to your registration appointment:
- INCOME DOCUMENTATION: SNAP letter, current pay stub, w-2 or 2024 tax form, child support letter, or SSI letter
- STATE BIRTH CERTIFICATE
- SOCIAL SECURITY CARD
- MEDICAID/MEDCIAL INSURANCE CARD
- IMMUNIZATION RECORD (from their doctor or the Health Department)
- PHYSICAL (current well child checkup)
- DENTAL (current exam)
- CUSTODY/COURT DOCUMENTS (if they apply)
**Please be patient with our response to your inquiry as we have very limited summer hours. One of the Family Advocates will be in touch with you the next time they are in the office.**
Student ID: (Office use only)
Student's Full Name:*

First NameMiddle NameLast NameSuffix
Birth Date*

MonthDayYear
Date
Age:*
Sex:*

MaleFemale
Home Langauge:*
Mailing/PO Box Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Physical Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
County of Residence:*
Parent/Legal Guardian (Student lives with)
Primary Parent/Guardian 1:*
Relationship to Student:*
Phone 1:*
Email:*
example@example.com
Parent/Guardian Signature:

Clear
Date:

MonthDayYear
Date
Please verify that you are human*
Should be Empty:

Morgan County Universal Pre-K Interest Form

Parent/Legal Guardian (Student lives with)