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About
- Who We Serve
- Home
Programs
Events
- Diamonds & Denim Dinner Theatre
- Kids Fair
Support Kids
Shop
Contact

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Head Start Interest Form

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Head Start Interest Form

Your Name *

First

Last

Email *

Place of Residence *

Please indicate which city or town you live in

Phone Number

Age of child or children (check all that apply) *

0-2 years old
3-5 years old

I'm interested in the following: (check all that apply) *

Early Head Start/preschool in a classroom setting (children ages 0-2)
Head Start/preschool in a classroom setting (children ages 3-5)
A teacher coming to my home with activities (children ages 0-5)
Full-time child care

Preferred time to contact me (check all that apply)

Morning (8 a.m. – noon)
Afternoon (1p.m. – 4 p.m.)
Evening (5 p.m. – 8 p.m.)
Prefer to be contacted by email

Please leave comments or messages for staff here

How did you hear about us? (check all that apply) *

Family or Friend
Youth & Family Services Website
Billboard
Television
Radio
Internet Search
Social Media (Facebook/Instagram/etc.)
School, doctor, other agency
Other

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Our Mission

Supporting children and their families in being capable, caring, and contributing members of the community.

Youth & Family Services is a United Way partner agency.

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Youth & Family Services
1920 N Plaza Blvd.
PO Box 2813
Rapid City, SD 57709-2813
Phone: (605) 342-4195

Youth & Family Services Incorporated 2016 All Rights Reserved.

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