YMCA of Greater Erie

Pre-Kindergarten Transition Form B

To prepare for your child’s transition into a pre-kindergarten program, it is important to understand your intent regarding how your child’s on-going care will be funded. You have previously completed this form, this request is to ensure that your funding plan has not changed, or to assist you in changes you may need to make.

Child's Name(Required)

Child's DOB(Required)

Please check the statement that applies:(Required)

We are ONLY interested in Child Care Subsidy (eligibility will be determined by ELRC). We are not interested in Pennsylvania PreK Counts.

We are ONLY interested in Pennsylvania PreK Counts (eligibility and enrollment will be determined by the PKC program and will occur based on program’s school year recruitment timeline). We are not interested in Child Care Subsidy.

We are interested in BOTH Child Care Subsidy (eligibility will be determined by ELRC) AND Pennsylvania PreK Counts (eligibility and enrollment be determined by the PKC program and will occur based on program’s school year recruitment timeline).

We are NOT interested in EITHER Child Care Subsidy OR Pennsylvania PreK Counts.

If you have chosen ELRC funding, have you received your redetermination paperwork yet?(Required)

Yes

N/A

Parent/Guardian Name(Required)

Parent/Guardian Email(Required)

Parent/Guardian Signature(Required)

Date(Required)