Please fill in your contact information with address and phone number and a Family Advocate will call you to complete the process.
Parent/Guardian
Please provide us with basic information to get your child's application started. Then a Family Advocate will call to schedule a time to complete your applications.
First Name (Required)
Last Name (Required)
Suffix
Nickname
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 (Required)
American Indian or Alaska Native
Asian
Black or African American
Multi-racial/Biracial
Native Hawaiian/Other Pacific Islander
Other
Unspecified
White
English Proficiency (Required)
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
Highest Grade Completed (Required)
Associate's Degree
Bachelor's Degree
College Degree/Training Cert.
College or Advance Training
General Education Diploma
Grade 10
Grade 11
Grade 12
Grade 9 or less
High School Graduate
Master's Degree
Employment Status (Required)
Full-time & Training
Full-time (35 hours/week or more)
Part-time & Training
Part-time (Under 35 hours/week)
Retired or Disabled
Seasonally Employed
Training or School
Unemployed
Custody (Required)
Yes
No
Teen Parent
Yes
No
If Teen Parent, Subsidized?
Yes
No
Address
Please fill in your current living and mailing address if different.
Is your family experiencing homelessness?
Yes
No
Living Address (Required)
Address Line 2
City (Required)
State (Required)
ZIP (Required)
Click here
to find a provider in your area.
Mailing Address same as Living Address
Mailing Address
Address Line 2
City
State
ZIP
Additional Parent/Guardian
Is there another parent/guardian in the family?
Yes
No
First Name (Required)
Middle Name
Last Name (Required)
Suffix
Birthday (Required)
Gender
Female
Male
Email Address
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.
Child (Applicant)
First Name (Required)
Middle Name
Last Name (Required)
Suffix
Nickname
Birthday (Required)
Gender (Required)
Female
Male
Race (Required)
American Indian or Alaska Native
Asian
Black or African American
Multi-racial/Biracial
Native Hawaiian/Other Pacific Islander
Other
Unspecified
White
English Proficiency (Required)
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)
EHS 2024-2025
school for ages: pregnant moms and 6 weeks to age 3
Head Start 24-25
Preschool for children ages 3 to 5
Location Preference
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1st Location Preference
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2nd Location Preference
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3rd 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.