Amherst County Public Schools Smart Start              Application Form 2022-2023
Families in Amherst County have opportunities to apply and be considered for two types of preschool programs.  Each program is described below.

Program 1: Amherst County Public Schools Smart Start programs are free; full-day application based preschool programs that meet all Virginia State Standards for preschool education for your 4-year-old.   There is no cost for breakfast, lunch, and snack.  All school supplies are provided.  Transportation is available.

Program 2: Four year olds who are found eligible for the Smart Start program may also be eligible for a free Mixed Delivery Pre-K which is a grant-funded program, through Bright Beginnings Central Virginia, that places children in preschool programs in private childcare centers located within Amherst County.  A limited number of slots are available to eligible families.  Before and after care options may be available.  Transportation is not provided.

All information provided in this application is collected and reviewed/stored in a confidential manner. This information is used to determine eligibility for the 4 year old Smart Start preschool program (Program 1), and if indicated by parent, may also be used to determine eligibility for other programs offered through Bright Beginnings Central VA grants (Program 2).
Email *
With the limited number of spaces in each program, please indicate which program/s you would like to apply and be considered for.
Clear selection
If you chose only one program and it is determined that you are not eligible or accepted into that program choice, are you willing to learn about other program options that are available? *
Child's Last Name *
Child's First Name *
Date of Birth (must turn 4 on or before September 30, 2022) *
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Sex *
Race *
Street Address of student enrolling, and parent/guardian: *
City *
State *
Zip Code *
Name of Parent/Guardian who is enrolling child: *
Relationship to child: *
Home Phone Number *
Work Phone Number *
Cell Phone Number *
Number of Children in the household *
Number of Adults in the household *
Name of Emergency Contact: *
Relationship of emergency contact to child: *
Emergency Contact Phone Number *
Does your child currently have an Individualized Education Plan (IEP) *
If your child does have an IEP, is he/she attending an early childhood special education program? *
If attending an early childhood special education program, what is the name of the early childhood special education preschool?
Is your family currently receiving any of the following forms of income and/or assistance? (check all that apply) *
Required
Do any of the following situations apply to your family? (check all that apply) *
Required
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