Child And Family Information Form Page 3
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3*Updated 06/24/2012*
ELN Data Fields Form
Child and Family Information
Child Enrollment Information
Complete the following table for each of the classrooms in which the child is enrolled.
Classroom
Physical
Classroom
Classroom
Program
Sub
Funding
-Days per
-Hours per
Schedule*
Session
Room*
Session
Session
(Select all
Program*
Source*
week
week
(Select one)
that apply)
-Full Day
(Options
(Options
Name*
Begin
End Date
- Head Start
-Half Day
depend on
depend on
Date*
-Days per
-Hours per
- PA Pre-K
Program
Program
month
month
Counts
selection)
selection)
- School
- Early Head
-
Child Care
District Pre-
Start
Works
K
- Head Start-
Subsidy
-Keystone
(Pre-
-No Child
Stars
School)
Care Works
-Other
-PA-Pact-
Subsidy
ACT
-Federal
-PA-Pact-
-State-
ABG
OCDEL
-Title I
-State-Pass
-Child Care
Through/AR
-Keystone
RA
Stars
-Both State
-School
and Federal
District
-Local
Pre-K
-PA Pre-K
Counts
-N/A
Page 3 of 3
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