Please complete the form below to begin your application process for the Head Start Program with Easterseals Early Learning Services. Please be sure to provide current and accurate information regarding your child and family, as this will ensure the application process goes as quickly as possible. Completing this form is the first step in the application process. A member of our team will be in contact with you after your interest form is submitted. If you need to speak with a staff member sooner or have an urgent matter, please cal 331-264-4295 Monday - Friday between 8:30 AM - 4:00 PM.
The primary adult must live in the home with the child applicant.
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Child Applicant Information
- Your Address - Available Locations
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Do you want to apply now for another child in your family?

Add Another Applicant
Thank you for submitting a pre-application for Easterseals Early Learning Services. This is the first step of the application process. If available, please upload your child's birth certificate, income documentation, physical, and dental in the application link. Our intake team is awaiting the opportunity to speak with you. Please call 331-264-4295 Monday - Friday between 8:30 AM - 4:00 PM. We look forward to speaking with you within the next 2 business days.
Required information is missing, see above.