23-24 GSRP Waitlist Reporting- Wayne County
To complete this form, please indicate your Program Name and enter the name of one listed guardian, phone number, and zip code for each child on your waitlist. 
Please submit a new entry for each child on your waitlist - please contact your ECC for assistance, if needed.
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Email *
Program / Subrecipient Name *
Program Zip code *
Waitlist Reporting
Parent/Guardian First Name *
Parent/Guardian Last Name *
Parent/Guardian Phone Number *
Zip Code of Family *
You have reached the end of the survey. Please click 'submit' to send your responses. Thank you for your time!
A copy of your responses will be emailed to the address you provided.
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