Apply Online

Thank you for your interest in our Head Start program. Please complete the initial application below. Someone from our staff will contact you to make an appointment to come in and finish the paperwork. To check for income eligibility, please check: https://aspe.hhs.gov/poverty-guidelines

First Name (Required)

Middle Name

Last Name (Required)

Suffix

Birthday (Required)

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

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's Relationship

Custody

Lives with Family

Is your family experiencing homelessness?

Living Address (Required)

Address Line 2

City (Required)

State (Required)

ZIP (Required)

Click here to find a provider in your area.

Is there another parent/guardian in the family?

First Name (Required)

Middle Name

Last Name (Required)

Suffix

Birthday (Required)

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

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's Relationship

Custody

Lives with Family

First Name (Required)

Middle Name

Last Name (Required)

Suffix

Nickname

Birthday (Required)

Gender

Race

Hispanic

English Proficiency

Other Language

Primary Health Coverage

Doctor/Medical Home

Dental Coverage

Dentist/Dental Home

Does your child have a disability or do you have any concerns about your child's development?

Is there anything else you want to tell us about your child?

Which program are you applying for? (Required)

1st Location Preference

2nd Location Preference

- Your Address - Available Locations

Click a location on the map to see more info

Click here to find a provider in your area.

Do you want to apply now for another child in your family?

Add Another Applicant

Are there other children in the family?

Add a Sibling

Documentation regarding income, proof of residency, a copy of the long-form birth certificate, and a current physical must be provided. Please go to our website for a list of the required items: http://publicschools.manchesterct.gov/uploaded/Preschool_Center/Files/Items_to_bring_to_registration_16-17.pdf

Required information is missing, see above.

Parent/Guardian

Address

Additional Parent/Guardian

Child (Applicant)

Location Preferences

Additional Applicant

Siblings