Applicant Information (Print all information) Please use a pen to fill out the application. Selection for enrollment will be based on: income, age, geographic location, employment/educational needs, special need of a child and family needs. ATTACH THE FOLLOWING DOCUMENTS TO THIS APPLICATION: ⃞ Verification of age. (State certified birth certificate, baptismal certificate or hospital record). ⃞ Proof of income that shows total family income. (Prior year’s tax return 2010, 3 or more pay stubs, written statement from employer, TANF, scholarships, and financial aid). Incomplete application will not be considered for enrollment AGE ELIGIBILITY OF CHILDREN Priority will be given to children who are 4 years of age prior to September 1. INCOME ELIGIBILITY To qualify, the family’s income must be below the 2011 income guidelines
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