Apply Online

Thank you for your interest in Early Childhood Programs for the 2025-2026 school year. Allow yourself 20 minutes to complete the online pre-application in its entirety, as you will not have an opportunity to return to an application or save any responses. **************** Please gather required supporting documents before starting the application: Birth Certificate, parent photo ID, proof of residency (current electric or water bill with the service address and parent name), and income documentation (W2s or Tax Form 1040, SNAP/SSI Benefit Letter, etc). You will have an opportunity to upload all supporting documents into our secure database at the end of this portion of the application.

Primary adult is the child's parent or guardian by blood, marriage, or adoption. Please name the adult who is legal guardian of the child and who is financial reasonable for the child.

First Name (Required)

Middle Name

Last Name (Required)

Nickname

Birthday (Required)

Gender (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 (Required)

Opt In for Text Messages

Home Phone (Required)

Work Phone (Required)

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)

Hispanic (Required)

Lives with Family

English Proficiency (Required)

Other Language

Other Language Proficiency

Highest Grade Completed (Required)

Employment Status (Required)

Child's Relationship

Custody

Provides Financial Support

Teen Parent

Please type the address where your child lives.

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.

Mailing Address same as Living Address

Mailing Address

Address Line 2

City

State

ZIP

The secondary parent is the child's parent or guardian by blood, marriage, or adoption; authorized care-giver or legally responsible party. Only list the secondary parent if they live in the home with the child.

Is there another parent/guardian in the family?

First Name (Required)

Middle Name

Last Name (Required)

Suffix

Nickname

Birthday (Required)

Gender

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.

Race

Hispanic

Lives with Family

English Proficiency

Other Language

Other Language Proficiency

Highest Grade Completed

Employment Status

Child's Relationship

Custody

Provides Financial Support

Teen Parent

Family means all person living in the same household who are supported by you, the parent, guardian, or care-giver. An emergency contact is a local family member, friend, or neighbor we may contact in case of emergency or if we are unable to contact you at the phone number or email provided on your application.

Number of Parents/Guardians

Relationship to Participant(s) (Required)

Primary Language at Home (Required)

Is another language being acquired or learned at home?

Is your family receiving cash benefits or other services under the Temporary Assistance for Needy Families (TANF) program? (Required)

Is your family receiving Supplemental Security Income (SSI)? (Required)

Is your family receiving services from WIC? (Required)

Is your family receiving services under the Supplemental Nutrition Assistance Program (SNAP), formerly referred to as Food Stamps? (Required)

Is at least one parent/guardian an active duty member of the United States military?

Is at least one parent/guardian a veteran of the United States military?

Add Emergency Contact

Provide information for the child for which you are submitting an application for.

First Name (Required)

Middle Name

Last Name (Required)

Suffix

Nickname

Birthday (Required)

Gender (Required)

Race (Required)

Hispanic (Required)

English Proficiency (Required)

Other Language

Other Language Proficiency

Primary Health Coverage

Other Coverage

Medicaid Eligibility

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?

How did you hear about us

Expectant Mother

Which program are you applying for? (Required)

Location Preference

1st Location Preference

2nd Location Preference

3rd 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

Thank you for completing the first steps in applying for our Early Childhood Program. Click "Save and Continue" for your information to be received in our online database. A staff member will be in contact with you to complete the interview portion of the application process and finalize documentation.

Required information is missing, see above.

Parent/Guardian

Address

Additional Parent/Guardian

Family Information

Emergency Contacts

Child (Applicant)

Location Preferences

Additional Applicant

Siblings