Scholarship Grant Application This Survey has been created by the NHA IT Department and Surveys should never ask for any sensitive or secure data. Do not provide passwords, SSN, credit card numbers, identification numbers, or any other sensitive information. OK Question Title * Program Option Full Day (6 hours) Full working day (6 hours+) OK Question Title * Site Preference: OK Question Title * Site Preference #2: OK Question Title * Has the child you are applying for previously been enrolled in our program? Yes No previous enrollment OK Question Title * If Yes Head Start Early Head Start OK Question Title * Is any member of your household employed with NHA? Yes No OK Question Title * If yes: Name of Employee: OK NEXT