2. 

4. Age Eligibility:

6. My child will be UNDER three (3) years old on or before August 31, 2023 to qualify for up to 4 hours a day of preschool funding for the school year September 1, 2023 – June 30, 2024. The maximum funding will be $2,500 for the school year.

   1. Yes
   2. No
7. My child will be three (3) years old on or before August 31, 2023 to qualify for up to 4 hours a day of preschool funding for the school year September 1, 2023 – June 30, 2024. The maximum funding will be $5,000 for the school year.

   1. Yes
   2. No
8. My child will be four (4) years old on or before August 31, 2023 to qualify for up to 7 hours a day of preschool funding for the school year September 1, 2023 – June 30, 2024. The maximum funding will be $10,000 for the school year.

   1. Yes
   2. No

12. Required Documents:

14. Copy of Birth Certificate of Child
15. Utility Bill in Parent’s or Guardian’s Name at an Eastham Address:
16. Copy of Eastham Real Estate Tax Bill in the Name of the Parent or Guardian (if applicable):
17. Copy of Lease for an Eastham property in the name of the parent or guardian (if applicable):

21. Child's Information: 

23. First Name
24. Last Name
26. Date of Birth:
    Date of Birth:

30. Parent(s) or Guardian(s) Information:

32. Name of Parent(s) or Guardian(s):
34. Address
36. Mailing Address (if different):
38. Number of Years at Address:
40. Email Address
41. Phone Number
43. Are you a Town of Eastham Employee?

    1. Yes
    2. No

47. School/Provider Information:

49. Name of School
50. Contact at School:
52. Is the School/Provider a Massachusetts licensed provider on Cape Cod?

    1. Yes
    2. No
54. Address
56. Phone Number
57. Email Address

61. On receipt of your application, with proof of residency, we can begin payment, directly to any licensed provider. The school or provider will bill for services at the end of each month and be paid directly by the Town of Eastham.

    
    

    Any questions or concerns contact Kayla Urquhart in the Administration Office at 

    508-240-5900 x 3207.

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63. 1. Receive an email copy of this form.
64. Email address

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65. Submit

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