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Email *
2021-2022 Preschool Application
Name of person filling out this application. *
2021-2022 Vernon Parish Preschool Coordinated Enrollment Application
By completing this application you are applying for a spot in one of the Vernon Parish preschool programs.  Completion of this application does not guarantee a spot in a program.
Child's First Name *
Child's Last Name *
Today's Date *
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Gender *
Child's Birthdate                                                             (Complete the application ONLY if your child turns age 4 between Oct 1, 2016 - Sept. 30, 2017) *
MM
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DD
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Ethnicity *
Phone number (please provide two phone numbers) *
Physical Address (Street, City, State, Zip) *
Father/Guardian's Name
Mother/Guardian's Name
List person child resides with and relationship to the child
Number of Adults in the Household *
Number of Children in the Household *
Total Number of Household Members (number of children + number of adults)  Include only those who are permanent members of the household.   *
Number of children in your household who could be served in a Birth-2 year old program?
Total Monthly Household Income (LA4 - Base Pay Only; Head Start needs ALL income)  Include income for ALL adults living in the household. *
Check all that apply to the child *
Yes
No
Not sure
Currently enrolled in Vernon Parish Head Start program
Receives Special Education Services
Currently attends a child care center
Child is a military dependent
Family receives Food Stamps (SNAP)
Child receives Medicaid
Child in foster care
Provide details if currently receiving special health or education services
Please select your program preference *
Please select your site preference.   *
Optional: Upload your required documents prior to the registration event!
Use a scanner or your phone to scan each required document needed to complete the registration process.
 
#1 - If using your phone - open Notes, and select to create a note.
#2- Tap the camera button, then tap Scan Documents.
#3 -Place your document in view of the camera. If your device is in Auto mode, your document will automatically scan.
#4 -Tap save or add additional scans to the document.

Optional: Email to vpp@vpsb.us and place your child's name in the subject line.

This will help our team have your folder completed and ready to verify at the enrollment event.  
A copy of your responses will be emailed to the address you provided.
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