Head Start Intake Form Child's Information Child's Legal Name * Date of Birth * Preferred Location * Southside Center: 475 Elwood Ave. Columbus, OH 43207Watkins Classroom: 1520 Watkins Rd. Columbus, OH 43207Moler Classrooms: 1201 Moler Rd. Columbus, OH 43207 Parent Information Parent(s) Name * Email * Home Address * Home Number Cell Phone * Primary Language *
