Form 1 Monthly Enrollment

OMB Control No: 0970-0427
Expiration date: X/XX/XXXX

Monthly Enrollment
The following information is collected at the program level and/or center-level.
Operated this month:
Last day of services provided:
Funded Enrollment:
Head Start Enrollment:

Comments:
Initially Reported:
Last Modified:

Yes/No
[Date]
[Pre-populated field]
[Enrolled – numerical field]
[Reserved]
[Vacant (less than 30 days)
[Monthly Total – Calculated field]
[Text Field]
[Pre-populated field]
[Pre-populated field]

Definitions:
Operational (or any variation of) — the program was open and children were enrolled during the month.
Enrolled - Report the total number of children (and pregnant women in Early Head Start programs) that have been
accepted and attended at least one class (or at least one home visit for the home-based option) on the last
operating day of the requested month (see Head Start Performance Standards section 1305.2).
Reserved - Report any slots reserved for families experiencing homelessness or children in foster care. No more
than 3 percent of a program's funded enrollment slots may be reserved. If reserved slots are not filled within 30
days, they become regular vacancies which can be counted as enrolled slots for up to 30 days (see Head Start
Performance Standards section 1302.15(c)).
Vacant (less than 30 days) - Report any slots that were vacant less than 30 days as enrolled. After 30 days, the
slot is not counted as enrolled (see Head Start Performance Standards section 1302.15(a)).

THE PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) Public reporting burden for this
collection of information is estimated to average 0.05 hours per response, including the time for
reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of
information. An agency may not conduct or sponsor, and a person is not required to respond to, a
collection of information unless it displays a currently valid OMB control number.

Questions for Enrollment Reporting Due to COVID-19
Impacted by Natural Disaster:
[HS/EHS] Status of in Person Services:

[HS/EHS] Was the center closed at any point in the past month due
to COVID-19:
[HS/EHS] Program Option

# of [HS/EHS] Children in Person Only

[Yes/No]
[Open for in person program
services/Closed for in-person services
due to COVID-19/Closed for in-person
services due to natural disaster/
Closed for in person program services
because it is not in season]
[Yes/No]
[Center-based/Home-based or
services to pregnant women/Family
child care/Locally designed
option/More than one program
option]
[Numerical Entry Field]

# of [HS/EHS] Children Virtual/Remote Only

[Numerical Entry Field]

# of [HS/EHS] Children in both in Person and Virtual/Remote

[Numerical Entry Field]

Notes Regarding Center/Program:

[Text Box]