GSRP Enrollment Contact Information

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GSRP Enrollment Contact Information - MiECC (24-25SY)

This form is intended to capture contact information for individuals who complete your program's enrollment activities. Information submitted here does not replace or impact your Hub Contact elections.

Please note, personal emails cannot be used for MiECC notifications due to sensitive child information contained within those messages.

For questions or challenges with completing this submission form, please contact Early Childhood (earlychildhood@resa.net) or (734) 334-1312.

Service Provider Name *

Building Name
*

Last Name *

First Name *

Email
This is where all communications will be sent and will be used as your login. *

Are you the primary enrollment contact for your program? (This person will receive notifications for all new applications/communications.) *

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