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Detroit Leadership Academy Pre-K Pre-Enrollment
Please note: this interest form does not guarantee enrollment in this Great Start Readiness Program (GSRP).
These materials were developed under a grant awarded by the Michigan Department of Education
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* Indicates required question
Email
*
Your email
Child's Date of Birth (must be 4 before December 1, 2023):
*
MM
/
DD
/
YYYY
Sex:
*
Female
Male
Prefer not to say
Other:
Child's Name:
*
Your answer
Child's Address:
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Your answer
Phone Number:
*
Your answer
Alternate Phone Number:
Your answer
Alternate Phone Number:
Your answer
Parent/Guardian's Name:
*
Your answer
Parent/Guardian's Name:
Your answer
Number of ALL (self, children, and other adults) household members for which you are financially responsible:
*
Your answer
Gross (before taxes) Income: (Frequency of pay)
*
Your answer
I acknowledge the following documents are needed for enrolment:
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Documentation of Income
Proof of Immunizations
Health Appraisal (completed and signed by doctor)
Copy of Birth Certificate
Parent Identification
Required
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