The following is a pre-enrollment for entry into the PRIDE Community Services Head Start Program for the 2025-2026 program year. Please complete the required information and someone will contact you to schedule an appointment to complete the enrollment process. If you already have applied or currently have a child in the program, you will not be able to complete the online pre-enrollment. Please call 304-752-6868 to initiate the process. If your child is five years or older by July 1, 2025, Please contact your home school for kindergarten enrollment.
Parent/Guardian
The primary adult is the legal guardian of the child.
First Name (Required)
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.
SSN
Race
American Indian or Alaska Native
Asian
Black or African American
Multi-racial/Biracial
Native Hawaiian/Other Pacific Islander
Other
Unspecified
White
Hispanic
Yes
No
Highest Grade Completed
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
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
Address
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
Secondary Adult (is the Father/Mother/Guardian). The birth date for each adult is an area that must be completed.
Is there another parent/guardian in the family?
Yes
No
First Name (Required)
Last Name (Required)
Birthday (Required)
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.
Family Information
Verification of income is a requirement for Head Start enrollment. The income information will be kept strictly confidential. This information is critical for funding and other grants that our county receives. For TANF, SSI, WIC or SNAP only answer 'Yes' if you are currently receiving those benefits. Proof of Income and copies of awards letters will be requested for Head Start enrollment.
Relationship to Participant(s)
Foster parent(s) not including relatives
Grandparent(s)
Other
Parent(s) (e.g. biological, adoptive, stepparents)
Relative(s) other than grandparents
Number in Family
Gross Annual Income
Is your family receiving Supplemental Security Income (SSI)?
Yes
No
Is your family receiving services from WIC?
Yes
No
WIC ID (if applicable)
Emergency Contacts
Add Emergency Contact
Child (Applicant)
First Name (Required)
Last Name (Required)
Birthday (Required)
Location Preferences
Which program are you applying for? (Required)
PRIDE Community Services, Head Start Program
Free Preschool for Children Ages 3-5
PRIDE Community Services, Head Start Program
Free preschool for children 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
You will receive a confirmation once the pre-enrollment is submitted. A certificate of Live Birth from the Office of Vital Statistics of the state where child was born, must be presented to staff prior to attendance. The certificate must have the original seal.
Required information is missing, see above.