Clifton Head Start Program

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Head Start is a full day program for four-year-old students and is located at Clifton Early Childhood School. Students in Head Start must meet the Head Start eligibility criteria. Parents who complete this form will be contacted by Head Start staff to begin the enrollment procedures.

Email *

Parent First Name *

Parent Last Name *

Home Address - Must Live within Irving ISD boundaries unless the parent is an Irving ISD employee *

Phone Number *

Child's First Name *

Child's Last Name *

Child's Date of Birth - Child must be 4-years-old by September 1, 2021 *

YYYY

Are you currently an Irving ISD Employee? *

Yes

Please read carefully and check all boxes to agree. *

I understand that I am completing this form because I am interested in the Head Start Program

I understand that the Head Start program is located only at the three Early Childhood Campuses (Clifton, Kinkeade, and Pierce)

I understand that completing this form does not mean that I am automatically enrolled in Head Start.

I understand that I will be contacted by a Head Start Liaison to complete my enrollment into Head Start.

I understand that completing this form does not enroll my child in Irving ISD and I will also need to complete registration through Infosnap.

Other:

Required

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