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Benton Franklin Head Start Program Interest Letter
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* Indicates required question
Name of Parent/Guardian
Nombre del padre o madre/guardian
*
Your answer
Parent/Guardian's Date of Birth
Fecha de nacimiento del padre o madre/guardian
*
MM
/
DD
/
YYYY
Mailing Address/
Dirección de envio
*
Your answer
City/
Ciudad
*
Benton City
Kennewick
Pasco
Richland
Other:
Zip code/
Código postal
*
Your answer
Phone Number/
Número de teléfono
*
Your answer
Cell phone/
Teléfono móvil
Your answer
Work number /
Numero de trabajo
Your answer
Email address/
Dirección de correo electrónico
Your answer
Language Spoken in the home/
Idiomas que se hablan en el hogar
*
English/Inglés
Spanish/Español
Other:
Additional Contact/
Contacto adicional
*
Your answer
Phone Number/
Número de teléfono
*
Your answer
Applicant's Name/ N
ombre del solicitante
*
Your answer
Date of Birth/Fecha de nacimiento
*
MM
/
DD
/
YYYY
Applicant's Name/ N
ombre del solicitante
Your answer
Date of Birth/Fecha de nacimiento
MM
/
DD
/
YYYY
Applicant's Name/ N
ombre del solicitante
Your answer
Date of Birth/Fecha de nacimiento
MM
/
DD
/
YYYY
How did you hear about us?/
¿Cómo te enteraste de nosotros?
*
Friend/Family
Television Commercial
Facebook
Community Event
My child is currently in Early Head Start
I received a BFHS Postcard in the mail
Flyer/Poster
School District
Other:
Required
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