Rosemount Center Application

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Rosemount Center Application

Please complete all 7 sections of the application to the best of your ability.
If you are currently pregnant, please indicate the last name of the child and the due date. Note: When the child is born please call the enrollment department at Rosemount Center to update the information.

Enrollment Options

Early Head Start (EHS):

Financial assistance for families who qualify, center-based and home-based program

DC Department of Human Services assistance (DHS):

Financial assistance for families who qualify, tuition center-based program

Tuition:

Center-based program

Note: EHS/OSSE applicant must be a DC resident in order to qualify for the program.


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Applicant

(Child Applying for Services)
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Primary Adult

(Lives with child)
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Contact Information

for Primary Adult lives with Child
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Secondary Adult

(Lives with child)

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Contact Information

for Secondary Adult
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Family/Household Information

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Children in family living with child
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Family Members

(Please do not include adults and child listed previously)
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Family Member (1)

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Family Member (2)

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Family Member (3)

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Family Member (4)

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Family Member (5)

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Government Funding Information

To be considered for Early Head Start and/or DHS (District of Columbia), please indicate which of the following services your family receives. (Check all that apply)

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Development Information

Do you have any concerns about your child’s development, physical, or emotional progress? Has your child ever been assessed for special need? Does your child have an IEP or IFSP? If yes, please explain.
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Need More Info?

For Tuition questions or clarification, please contact Marcia Rock at (202) 265-9885 ext.138.

For Early Head Start or OSSE questions, please contact Karla Alvarado at (202) 265-9885 ext. 104.

View the Admissions Applications: