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Kids Corp. Inc.

Alaska Based Head Start Agency

Head Start & Early Head Start

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Parents as Teachers Application

Step 1 of 5

20%
  • Date Format: MM slash DD slash YYYY
  • Child 1 Information

  • Date Format: MM slash DD slash YYYY
  • Child 2 Information

  • Date Format: MM slash DD slash YYYY
  • Parent/Guardian Information

  • Date Format: MM slash DD slash YYYY
  • Check all that apply
  • Parent/Guardian Information continued...

  • Digital Signature

  • Kids’ Corps, Inc. – Parents As Teachers
    101 Davis St. 
Anchorage, AK 99508
    Phone: 907-339-0154
    
Fax: 907-339-0148
    
Email: pat@kcialaska.org

    I certify that this information is true. If any part is false, my participation in this agency’s programs may be terminated and I may be subject to legal action. I also understand that the information in this application will be held in strict confidence within the agency and is accessible to me during normal business hours.



    By typing my name in the field below, I certify that the information provided in this application packet contains no willful misrepresentation or falsification and that the information given by me is true and complete to the best of my knowledge.

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Brochure and application for the Alaska Head Start Association (AHSA)   Alaska Head Start Brochure & Application  
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