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2020-2021 Preschool Application

Application for the 2020-2021 School Year 

begins, May 19, 2020


Click Here to Download Flyer

Apply here for enrollment through May 2021



The following information is required for your child to be enrolled in a program:

  • Child's Birth Certificate
  • Child's Shot Record
  • Child's Social Security
  • Proof of Residency
  • Proof of Household Income

    ____ Two (2) consecutive check stubs for EACH PARENT or CAREGIVER IN THE HOUSEHOLD for the current year (within 2 months from the date of filling out this application.) Use tables in the attached Eligibility Guidelines to calculate. 

    ____ An official letter from your employer stating all of the following:

    ____ SNAP/Food Stamps – must include the child’s name and valid effective dates.   

    ____ A statement from the Social Security Administration verifying that the child listed on the application is a recipient of SSI benefits, which must be accompanied by two current check stubs.

    ____ Current foster care placement agreement from the Department of Children and Family Services (DCFS)

    ____ Any adult in the household who claims zero income of any kind must submit a Statement of No Income form. (link to the document is below)

    ____ Parents or guardians who are employed intermittently, self- employed, or who do not have tax forms, W-2 forms, check stubs, or applicable DCFS printouts to verify their income must submit a Declaration of Income for Irregular Employment form. (link to the document is below)

    ____ Families in a temporary living arrangement due to loss of housing or economic hardship (homeless).  

    ____ Other: ______________________________________________________________________

    May be subject to review.
    Note for LA4 Program: 2019 tax documentation is allowable for the proof of income ONLY if no other form of income verification documentation exists. Previous tax years are not allowed.

    • Where parent/guardian is employed
    • Hourly rate of pay
    • The average number of hours parent/guardian works per week. 


LA4 Program: The required documents should be dropped off at the school you choose.  If you have any questions contact the LA4 office at 337-537-5145. 

Head Start: The required documents should be dropped off at the Head Start office at 1409 South 4th Street, Leesville, LA 71446. 337-239-6899