Please fill in your contact information and a Family Advocate will call you to complete the process.
Parent/Guardian
First Name (Required)
Middle Name
Last Name (Required)
Birthday (Required)
Gender
Female
Male
Email Address (Required)
Confirm Email Address
It appears that you have previously submitted an application. If you wish to apply again, please contact us by phone or in person.
Mobile Phone
Opt In for Text Messages
Yes
No
Home Phone
Work Phone
Ext.
It appears that you have previously submitted an application. If you wish to apply again, please contact us by phone or in person.
Race
American Indian or Alaska Native
Asian
Black or African American
Multi-racial/Biracial
Native Hawaiian/Other Pacific Islander
Other
Unspecified
White
English Proficiency
Little
Moderate
None
Proficient
Other Language
American Sign Language
Chinese
English
French
Guatamalan
Hindi
Japanese
Other
Sign Language
Spanish
Sudanese
Child's Relationship
Biological/Adopted/Step
Foster
Grandchild
Other
Other Relative
Address
Is your family experiencing homelessness?
Yes
No
Living Address (Required)
Address Line 2
City (Required)
State (Required)
ZIP (Required)
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to find a provider in your area.
Mailing Address same as Living Address
Mailing Address
Address Line 2
City
State
ZIP
Child (Applicant)
First Name (Required)
Middle Name
Last Name (Required)
Suffix
Nickname
Birthday (Required)
Gender
Female
Male
Race
American Indian or Alaska Native
Asian
Black or African American
Multi-racial/Biracial
Native Hawaiian/Other Pacific Islander
Other
Unspecified
White
English Proficiency
Little
Moderate
None
Proficient
Other Language
American Sign Language
Chinese
English
French
Guatamalan
Hindi
Japanese
Other
Sign Language
Spanish
Sudanese
Other Language Proficiency
Little
Moderate
None
Proficient
Is there anything else you want to tell us about your child?
Location Preferences
Which program are you applying for? (Required)
2022-2023 Head Start Application
A No cost to the parent Pre-school for ages 3 to school age.
2022-2023 Early Head Start Applications
Avaliable in Hamblen County Ages: Pregnant Mom's to 35 months
1st Location Preference
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2nd Location Preference
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- Your Address
- Available Locations
Click a location on the map to see more info
Click here
to find a provider in your area.
Additional Applicant
Do you want to apply now for another child in your family?
Add Another Applicant
Required information is missing, see above.