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Enrollment Short Form EXPO 2023
Welcome to Urban League Head Start! Please complete this short form and a Head Start/Early Head Start staff member will contact you to complete your enrollment! Thank You!
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Email
*
Your email
Your first and last name
*
Your answer
Your Mailing Address
*
Your answer
Your Email Address
*
Your answer
Best Phone Number to Reach You?
*
Your answer
How many children will be enrolling with us?
*
Only 1
2 children
3 or more children
Please provide the names, birthdate, and age of all children.
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Your answer
Have any of your children been enrolled with Urban League Head Start before?
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Yes
No
I don't know
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