Form AWI-VPK 02 Eligibility and Enrollment 02-14-2007.doc-2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling out the 'Certificate of Child Eligibility' section. Enter the VPK program year, certificate number, and issue date. Ensure you select whether this is a new enrollment or re-enrollment.
3. Provide the parent or guardian's name, daytime and home telephone numbers, and complete the home address fields including city, state, and ZIP+4 code.
4. Fill in the child's full name, social security number (if applicable), and date of birth. Choose the program type: either school-year or summer program.
5. In the 'Admission by Provider or School' section, enter the provider or school's name, contact details, address of the VPK site, class designation, and start date for attendance.
6. Ensure both provider/school and parent/guardian signatures are completed along with their respective dates.
7. Finally, review all entries for accuracy before submitting. Save your completed form for your records.

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