Type III Early Learning Center Application

RAPIDES EARLY CHILDHOOD NETWORK ENROLLMENT APPLICATION 2020-2021

For assistance completing the application, please call (318) 442-8891.
** This online application DOES NOT guarantee your child a seat in the location of choice. Academic screening and income eligibility will determine RPSD Pre-K eligibility. Income Eligibility will determine Save the Children Head Start and Early Head Start eligibility. Income Eligibility will determine if families will pay tuition or receive Child Care Assistance Program (CCAP) funds in Early Learning Centers.
Center Choice
STUDENT INFORMATION
Check here if this student does not have a middle name.
Ethnicity and Race Information

Ethnic/gender information is collected but not used for selection.

Ethnicity

Is this student Hispanic/Latino? (Defined as a person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.) *

Yes, Hispanic/Latino
No, Hispanic/Latino
Race
  • American Indian or Alaska Native
  • Asian
  • Black or African American
  • Native Hawaiian or Other Pacific Islander
  • White
Place of Birth
Family Information
Mother
Email address will be used for emergency and event notification
 
Check if this Parent/Guardian does not have an email address.
Father
Email address will be used for emergency and event notification
 
Check if this Parent/Guardian does not have an email address.
Employer
Preliminary Eligibility
  • 2 persons: $1,372
  • 3 persons: $1,732
  • 4 persons: $2,092
  • 5 persons: $2,452
  • 6 persons: $2,812
  • 7 persons: $3,172
  • 8 persons: $3,532
  • 9 persons: $3,892
Yes No

If you answered YES to all of the above questions, you may be eligible for child care assistance. Income limits are subject to change.

Referral
Parent/Guardian Signature

Rapides Parish School District treats the following signature like a signature on a paper form.

By signing this form electronically, you acknowledge that duplicate entries for this student can result in disqualification from the process.
Email Confirmation
Email address will be used for emergency and event notification

Note: Please review your information carefully. Once the submit button is pressed, you will no longer be able to change the information entered. Changes to your information can only be made in person at the district Early Childhood office.