Neck of the Woods Application
This form is an initial application for Infant, Toddler, and Preschool Programming. Once this form is completed, we will get back to you with Program availability within 3 business days.
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Email *
Child's Full Name (if you have one at this time) *
Child's Date of Birth or Due Date *
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DD
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Child's gender at birth (if known) *
Child's Ethnicity *
What is your current childcare situation?: (i.e. grandparents are watching my child, I'm taking time off of work, I may have to quit my job if I can't find care soon, my child is enrolled at another care program etc.) *
Requested Start Date *
MM
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DD
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Requested Days of Care *
Required
Parent/Guardian Name(s): *
Best Phone Number to reach you: *
Town of Residence *
Do you qualify for childcare financial assistance (Subsidized funding through the State)? *
Do you qualify for Head Start?

Head Start eligibility criteria must meet one of the following:

- Foster care
- Homelessness
- Receiving Public Assistance (TANF/Reach-up or SNAP (3squares))
- Someone in the household on SSI
- Income below federal poverty guidelines
 *
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