LCHS: HEAD START CONTACT ME FORM
For information on our Head Start, Early Head Start and Pre-K Counts programs please complete the following form to contact the Recruitment Office.
A Head Start Recruitment Staff Person will contact you within 3 Business Days.

Applications are accepted all year long for Head Start and Early Head Start programming in both Luzerne and Wyoming counties.

Recruitment season for our preschool program begins in January for the following school year.
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Parent/Legal Guardian's First Name *
Parent/Legal Guardian's Last Name *
Parent/Legal Guardian's Date of Birth
MM
/
DD
/
YYYY
Parent/Legal Guardian's E-Mail *
Confirm E-Mail *
Parent/Legal Guardian Address Line 1 *
Parent/Legal Guardian Address Line 2
City *
State *
Zip Code *
Parent/Legal Guardian's Phone/Cell Number *
Please indicate the best time to call *
Do you need a Spanish Speaking Staff Member to Contact You? *
How did you hear about us? *
If you chose 'Other Agency' from the previous list, please specify here:
Applying Child 1 First Name *
Applying Child 1 Last Name *
Applying Child 1 Birthdate *
MM/DD/YYYY
Applying Child 2 First Name
Applying Child 2 Last Name
Applying Child 2 Birthdate
MM/DD/YYYY
Applying Child 3 First Name
Applying Child 3 Last Name
Applying Child 3 Birthdate
MM/DD/YYYY
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