Interested in Enrolling Your Child?

Please complete our family Pre-Admission form

Child's First Name

Child's Last Name

Date of Birth

YYYY

Gender

Child's Childcare and/or Preschool Experience

Enter names of Centers and time period of attending, or write "none" if no prior care or preschool

Home Address

(Street Address)

City, State

Zip Code

Desired start date for care

YYYY

Parent/Guardian First Name

Parent/Guardian Last Name

Relationship to Child

Phone

(###)

###

####

Parent/Guardian First Name

(optional)

Parent/Guardian Last Name

(optional)

Relationship to Child

Phone

(###)

###

####

Number of Children and Adults in Household?

Household Income

Use the dropdown field below to specify weekly, monthly, or annual

Income amount per:

If your family may need tuition assistance, please answer the following:

Does your child or family currently receive benefits through the Department of Social Services? (e.g., SNAP, TANF, child care tuition assistance)?

Yes

For tuition assistance, Question 2:

Have you applied for tuition assistance through social services’ Child Care Subsidy Program (CCSP) through commonhelp.va.gov?

Yes

For tuition assistance, Question 3:

Have you applied for daycare/preschool services through Go2Grow.com?

Yes

TUITION ASSISTANCE Resources

Go2Grow works with local public schools, Head Start programs, and private providers to give all families access to early care and educational resources in Charlottesville, Albemarle, Fluvanna, Louisa, and Greene. By working together, we can ensure every child in the Greater Charlottesville area enters kindergarten ready to learn and grow! www.go2grow.com

An online guide for navigating and applying for public assistance including financial support for childcare. www.commonhelp.virginia.gov

Interested in Enrolling Your Child?

Please complete our family Pre-Admission form

We have received your information and will be in touch with you soon. Thank you!

TUITION ASSISTANCE Resources

Barrett Early Learning Center

HOURS

HELPFUL LINKS