Welcome to Lenawee County Preschools

Are you looking for free high quality preschool within Lenawee County for a child who is 3 to 5 years old and wondering if you qualify? Please fill out our interest form below or call 517-264-5324 to determine if your child is eligible to attend a FREE Great Start Readiness Program (GSRP) or FREE Head Start preschool program in Lenawee County. For more information on available local programs and eligibility criteria, click on About Us. Any family wishing to apply for GSRP or Head Start in Lenawee County must complete this interest form.

Please be aware that according to new state guidelines, all children must be 3 years old on or before September 1st to be eligible for Head Start. Children must be 4 years old on or before September 1st to be eligible for GSRP.

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Preschool Interest Form

School Year:
Please select the school year you are submitting this preschool interest form for:
2022-2023: Current school year, ending in June 2023.
2023-2024 : Next school year, beginning in September 2023.
Child's Information
Child's Name:

Date of Birth:
Gender: Male
Female
Ethnicity:
(check all that apply)
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
Hispanic of any race
Address:

Program Preferences:

Parent/Guardian Information
Parent/Guardian 1:

Providing your email address will ensure regular communication about preschool.

Phone Number:

() -

How would you prefer to be contacted?
 Phone
 Email
 Text
Parent/Guardian 2:

Phone Number:

() -

Address if different than child's:

Marital Status:
Single
Married
Divorced
Widow
Separated
Child Lives With (Primary Physical Custody):
(check all that apply)
Mother
Father
Both Parents (Same Household)
Both Parents (Different Household)
Joint Custody-Physical
Joint Custody Legal
Foster Care
Legal Guardian
Grandparent
Other:
Number of immediate family members living in the household:

Parent/Guardian 1 Income Information
Parent/Guardian 1 Gross Income:
Income before taxes or other deductions. Verification of income will be required.

Choose the period the above wage represents:

Any Additional Income:
(ex. Child support, rental income, etc)

Choose the period the above wage represents:

Parent/Guardian 1 Income Source:
(check all that apply)
Working
Child Support
Supplemental Security Income (SSI)
Temporary Assistance for Needy Families (Family Independence Program)
Supplemental Nutrition Assistance Program (SNAP)/Food Assistance Program (FAP)
Other:
Are you paying child support to Parent/Guardian 2?

Yes   No

Additional Information
Is there additional information that you can share about your child/family?
Rollover highlighted text for definitions.
Has your child been referred/involved in:
(check all that apply)
Early Childhood Special Education
Early Head Start
Early On
Head Start
If your child is currently receiving Early On or special education services, please select from the following:
 Individualized Family Service Plan (IFSP): Early On
 Individualized Education Program (IEP): Special Education
 No
Explain any concerns checked:
(i.e., evaluations, specialist, parent concern, lead count, primary language)

Is your child's current address a temporary living arrangement?

Yes   No

Would you like someone to follow up with you to discuss our Successful Kids=Involved Parents (SKIP) Program SKIP to a Great Start services include:
  • Monthly, interactive home visits with a Parent Educator
  • Parent-child playgroups focusing on healthy development
  • Developmental screenings
  • Parenting information
  • Connections to community resources for families
  • Newsletters with tips on nutrition, activities for families and children, and the playgroup calendar
?

Yes   No

Do you have reliable transportation?:
(for planning purposes only)

Yes   No

Current services received by family:
(check all that apply)
DHHS Child Care Assistance
DHHS Financial
DHHS Food Assistance
Medicaid
Women, Infants and Children (WIC)
I am pregnant and/or have a child birth to 3 and would like information on birth to 3 program options.

Yes   No

Is there anyone else that you would like to authorize the district or program to discuss enrollment with?

Yes   No

How did you learn about us?:
 Advertisement
 Community Organization
 Event
 Friend/Family Member
 Teacher/Education Professional
 Website
 Other:
 I understand and agree to having my information shared with local Head Start, Great Start Readiness Program, and Home Visiting Program providers.