Pre-K Counts

  • MM slash DD slash YYYY
  • Hidden
  • Please check box for type you will provided. (Documentation will be collected in a follow up email):
  • Hidden
    If the site chosen is full and you wish to participate virtually until a spot is available, please choose both options.
  • Do you have access to the technology required to use the Teaching Strategies app for communication in the event of a school closure?
  • (If a 2 parent household, income must be included for both parents)
  • Relationship to ChildAge 
  • Per PKC Statute, Regulations, and Guidance, the following members of the household are included in family size:

    • Parent of the child (biological or adoptive mother or father, stepmother or stepfather, caretaker or spouse)
    • A biological, adoptive, unrelated or foster child or stepchild of the parent or caretaker who is under 18 years of age and not emancipated.
    • A child who is 18 years of age or older but under 22 years of age who is enrolled in high school, a general educational development program, or a post-secondary program leading to a degree, diploma or certificate and who is wholly or partially dependent on the income of the parent or caretaker or spouse of the parent or caretaker.
    • Others supported by the income of the parent(s) or guardian(s) of the child enrolling or participating in the program. If counted toward family size, any applicable income of these persons must also be counted for eligibility purposes.

    Note: A family size value of one (1) with an income of $0 is entered when a foster child is applying for Pennsylvania Pre-K Counts.

  • (Required qualifying factor) Must be below 300% on income guideline chart to qualify: Please check box for your household income:
  • (Must check all that apply):
  • (Check all that apply)
  • Acknowledgment and Sign Off

  • Hidden
  • If your income is 100% of FPL or below, you are Head Start Eligible. You can find information on the program, including enrollment information at or by calling (814) 670-0643.

    For application and/or assistance with referral, contact [email protected].

    Persons in family/householdPoverty guideline
    1 $14,580
    2 $19,720
    3 $24,860
    4 $30,000
    5 $35,140
    6 $40,280
    7 $45,420
    8 $50,560
    Each Additional+$5,140
    My signature below indicates that I have been informed about my options but may still choose to enroll in the Pre-K Counts program.
  • Hidden
    MM slash DD slash YYYY