Private Industry Council of Westmoreland/Fayette, Inc.

Proudly Serving Southwestern Pennsylvania

Proudly Serving Southwestern Pennsylvania

219 Donohoe Road, Greensburg, PA 15601
Phone: 724-836-2600

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You are here: Home / Pre-K Online Application 

Pre-K Online Application 

Dear Parent/Guardian:
Thank you for your interest in the PA Pre-K Counts program. Please upload the following documents with your
application:
1. Your annual household income
2. Your child’s birth certificate

According to program regulations, annual household income (earned and unearned) is
required to establish eligibility.

The following are included in determining annual income:
a. Most recent W-2 Form (2020) or Most recent tax return (2020) or Pay stubs (last 30 days)
b. Unemployment Financial Determination Letter
c. SSI/Social Security Financial Award Letter
d. Child Support Information documenting (SCDU stub 0or court order) amount
received monthly
e. Unearned income including cash and contributions, dividends, interest, net income,
net royalties and periodic receipts from estates or trusts.

For questions call: 724-437-2590

Sincerely,
Pre-K Counts Staff

PA Pre-K Counts Family Application

  • General Information - Primary Adult

  • Phone NumberType (home, work, cell)Primary?Notes 
  • Family Income

  • Family MemberIncome SourceAmountPerAnnual Amount 
  • Emergency Contacts

  • NameRelationship to ChildCan release child to (Y/N)AddressPhone 1Phone 2Notes 
  • Primary / Legal Guardian Adult

  • Secondary Adult

  • Other Family Members

  • Adult / ChildLastFirstDOBGenderRelationship 
  • NOTICE: “All meals served to children under the Child Care Food Program are served at no separate charge regardless of race, color, sex, age, handicap, or national origin. There is no discrimination in admissions policy, meal service, or use of facilities. “Any complaints of discrimination should be submitted in writing within 180 days, of the incident to the Secretary of Agriculture, Washington, DC 20250.” Information from this application will be used for ongoing reporting/monitoring and assessment on a secured web-based system that is shared with multiple agencies (i.e. OCDEL, Head Start, CCIS, Early Intervention and other divisions within the Private Industry Council of Westmoreland/Fayette Inc).
  • Child Information

    Location subject to change
  • Max. file size: 50 MB.
  • Max. file size: 50 MB.
  • Max. file size: 50 MB.
    The following are included in determining annual income: a. Most recent W-2 Form (2019) or Most recent tax return (2019) or Pay stubs (last 30 days) b. Unemployment Financial Determination Letter c. SSI/Social Security Financial Award Letter d. Child Support Information documenting (SCDU stub 0or court order) amount received monthly e. Unearned income including cash and contributions, dividends, interest, net income, net royalties and periodic receipts from estates or trusts.
  • Max. file size: 50 MB.
  • Max. file size: 50 MB.
  • Max. file size: 50 MB.
  • Max. file size: 50 MB.

Contact PIC

219 Donohoe Rd,
Greensburg PA, 15601

724-836-2600
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Please be aware that the services of Private Industry Council are constantly changing and evolving. Any information contained on this website may refer to past events or services that are no longer available. In addition, programs and services may not be accurately or completely described.

You use this website at your own risk and no warranties, express or implied, are made about the website or programs or services being offered. We are not responsible for any loss or injury whatsoever due to the content or your use of this website.

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For the most up to date information on a particular program or service, or for general questions or concerns, please call our main office at 724-836-2600 or send e-mail for more information

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