Yes  Family is homeless: No (If yes you must explain living situation and fill out homeless information) Type of Housing:       House Apartment Mobile Home Community Shelter Homeless Hotel/Motel Other Family Housing Payment Type:    Exchange Services for Housing Make No Payment for Housing Own Rent Receive Subsidized Housing Other   Do you have of transportation? Yes No      Primary Mode of transportation: Personal Car Friends Car Bus Taxi Public Transportation Other How did your family hear about Head Start (Referral from where?)*
Family is homeless: Yes  No (If yes you must explain living situation and fill out homeless information) Type of Housing: House  Apartment  Mobile Home  Community Shelter  Homeless  Hotel/Motel  Other Family Housing Payment Type: Exchange Services for Housing  Make No Payment for Housing  Own  Rent Receive Subsidized Housing Other Do you have of transportation?  Yes  No Primary Mode of transportation:  Personal Car  Friends Car  Bus  Taxi  Public Transportation Other How did your family hear about Head Start (Referral from where?)*
2015-Application-Packet.docx