We are currently accepting applications for both the 2022-2023 and the 2023-2024 school years. Please complete as much of the following information as you can at this time. If you have any problems completing the application, please contact us at 1-855-654-6737 ext. 2306 or by email at Lreisz@hopes.org.
Parent/Guardian
Please complete the following information for the Primary Adult (parent/guardian) of the applicant.
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.
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)
Click here
to find a provider in your area.
Additional Parent/Guardian
Please complete the following information for the secondary adult (parent/guardian) of the child, if applicable.
Is there another parent/guardian in the family?
Yes
No
First Name (Required)
Last Name (Required)
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's Relationship
Biological/Adopted/Step
Foster
Grandchild
Other
Other Relative
Family Information
Number of Parents/Guardians
One Parent Family
Two Parent Family
Primary Language at Home
Albanian
American Sign Language
Arabic
Bulgarian
Chinese
Creole
Danish
Dari
English
French
German
Greek
Hebrew
Hindi
Hungarian
Igbo
Italian
Korean
Mandarin
Marathi
Portugese
Punjabi
Russian
Serbian
Slavic
Spanish
Swedish
Thai
Turkish
Uzbek
Number in Household
Number in Family
Is your family receiving cash benefits or other services under the Temporary Assistance for Needy Families (TANF) program?
Yes
No
Is your family receiving Supplemental Security Income (SSI)?
Yes
No
Is your family receiving services under the Supplemental Nutrition Assistance Program (SNAP), formerly referred to as Food Stamps?
Yes
No
Child (Applicant)
Please complete this information for each child you want to enroll in the program.
First Name (Required)
Last Name (Required)
Birthday (Required)
Gender
Female
Male
Does your child have a disability or do you have any concerns about your child's development?
Yes
No
Is there anything else you want to tell us about your child?
Location Preferences
Which program are you applying for? (Required)
State-Funded PreK 2023-2024
Head Start/State Funded 2023-2024
Head Start 2023-2024
Early Head Start 2023-2024
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
By submitting this application, I certify this information is true and correct to the best of my knowledge. Providing false information or purposely withholding information may result in my child's removal from the program and I may be subject to legal action. I also understand that the information in this application will be held in strict confidence within the agency and is accessible to me during normal business hours.
Required information is missing, see above.