House Hold Verification Form for Preschool Eligibility 2022-2023 Taylor County Preschool
Taylor County Preschool--The State Funded Preschool Program is available to children who are 4 years old on or before August 1 and whose family income is 160% poverty or less: and children who are 3 or 4 years old with identified disability.  To determine income eligibility, please complete this application.  
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Part 1. All Household Members (Names of all people living in your household) *
Part 2. Homeless Migrant, Runaway Status
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Part 3.  Types of Earnings *
List household member, type of earning, and earnings.  Indicate if you are paid monthly, bi-weekly, weekly, etc. for each type of earning (list earnings before deductions) Ex. John Doe- Child support $300 monthly *
Part 4. Guardian's Name *
Address *
City *
Zip Code *
Phone Number *
Date *
Child entering preschool *
Child's Date of Birth *
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