Green Trees Early Learning Center, Inc. Pre-K Counts Enrollment Inquiry

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Green Trees is proud to provide care for children in our Pre-K Counts Program! Pre-K Counts is a wonderful program and initiative with the state of Pennsylvania to provide tuition free early education for eligible children. Interest families should complete the form below. The Pre-K Counts class runs on the DV school calendar and meets Monday-Friday 8:30am-1:30pm. This form does not guarantee a placement, however it will place eligible families on our wait list when a placement becomes available. This is the first step in determining eligibility and obtaining a placement at our center. Please complete the form in its entirety to be considered, for any families who may need assistance in completing this form, please contact the center directly by calling 570 296 9404. Thank you!

Email *

Parent/ Guardian Name *

First and last name

Email *

Phone number *

This class meets Monday- Friday from 8:30am-1:30pm and follows the Delawae Valley School District Calendar This class DOES NOT meet on days that DV is closed (planned or unplanned such as snow days). Do you agree to have your child attend Monday-Friday at this schedule?

Yes

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Child Name *

First and last name

Birthday of Child (to be eligible for the 2024 school year, they must have turned 3 years of age on or before September 1st 2024)

YYYY

Are you a current resident of Pennsylvania?

Yes

Clear selection

Does your family meet the income eligibility guidelines? Please see the attached photo to confirm. Family size includes any adults and children that live in the home as their primary place of residence.

Yes

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What is your total household size, including yourself and your child(ren)?

Clear selection

Have you ever applied for Pre-K Counts or Head Start before? (any families who qualify for Head Start by income eligibility will receive information on local Head Start facilities, that family may still continue to enroll in the Pre-K Counts program)

Yes Pre-K Counts

Yes Head Start

Yes Both Programs

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Other Child Eligibility Risk Factors: please check ALL that apply.

Behavioral Supports- a child referred who is receiving mental health treatment.

Child Protective Services- a child who is a foster child, a kinship care child or receiving Children and Youth services.

Education Level of Guardian- Does not have a H.S diploma or GED or post-secondary educaiton.

English Language Leaner- a child whose first language is not Engligh and who is in the process of learning English is considered an English Language Leaner.

Individualized Education Plan- a child who is currently enrolled in the Preschool Early Intervention program with an active IEP. Verification would be a copy of the IEP or other source of documentation by the Early Intervention Provider.

Incarcerated Parent- a child whom one of the child's parents is currently in prison.

Homeless- a child who lacks a fixed, regular and adequate nighttime residence due to one of the following (a. children sharing the house of other persons due to loss of housing, economic hardship or similar reasons. b. children have a primary nighttime residence that is a public or private place not designed for regular sleeping accommodation for human beings. c. children who are living in cars, parks, public places, abandoned buildings, substandard housing, bus or train stations or similar.

Migrant (non-immigrant)/ Seasonal Student- migrant child moved from one school district to another in order to accompany or join a migrant parent.

Teen Mother: a child whose mother was under the age of 18 when the child was born.

Medical/ Disability- a child who has an identified chronic medical condition or identified medical disability, or a parental guardian who has an identified chronic condition or disability.

Covid-19- a child whose parent is facing medical concerns as a direct result of Covid-19.

Transportation & Commute- a child whose parent must commute to a neighboring state for their employment, or a child whose family has limited means of transporation.

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