Apply Online

Welcome to the Orange County Head Start Online Application! We’re excited that you’re interested in our Head Start program, which serves children ages 3–5 in high-quality early childhood settings. Our program supports children and families through school readiness, health and nutrition, social and emotional development, mental health resources, and family services all designed to help your child thrive. To apply, please complete all fields in the application. Our Head Start services are based on eligibility and the availability of program slots. If you have any questions or need help, we’re here for you! You can reach our Eligibility, Recruitment, Selection, Enrollment, and Attendance (ERSEA) team at 407-836-7602 or 407-836-6546, Monday through Friday, 8:00 a.m. to 5:00 p.m. Thank you for taking this important step toward your child’s early learning journey!

In this section, the primary adult (biological parent or legal guardian) of the applying child(ren) should be listed. All legal guardians and 50/50 parent custody must provide a court order proving guardianship or DCF custody.

First Name (Required)

Last Name (Required)

Birthday (Required)

Gender

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)

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.

SSN (Required)

Race and/or Ethnicity - To specify multiracial and/or multiethnic please check all races and/or ethnicities that apply (Required)

American Indian or Alaska Native

Asian

Black or African American

Hispanic or Latino

Middle Eastern or North African

Native Hawaiian or Pacific Islander

White

Prefer not to answer

Lives with Family (Required)

English Proficiency (Required)

Other Language (Required)

Other Language Proficiency (Required)

Highest Grade Completed (Required)

Employment Status (Required)

Child's Relationship (Required)

Custody (Required)

Provides Financial Support (Required)

Teen Parent (Required)

If Teen Parent, Subsidized? (Required)

Families applying for services must provide proof of residency in Orange County. Documents must be dated within 30 days of the application, and can be submitted at the in-person interview or emailed upon initial phone contact with a Family Services Worker. Acceptable proof includes a lease, utility bill (electric or gas), or a letter from the person you are residing with accompanied by a copy of their utility bill.

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

In this section do not list a secondary adult in the home if they are not the biological parent/legal guardian to the applying child or married to the biological parent/legal guardian.

Is there another parent/guardian in the family?

First Name (Required)

Middle Name

Last Name (Required)

Suffix

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)

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 and/or Ethnicity - To specify multiracial and/or multiethnic please check all races and/or ethnicities that apply (Required)

American Indian or Alaska Native

Asian

Black or African American

Hispanic or Latino

Middle Eastern or North African

Native Hawaiian or Pacific Islander

White

Prefer not to answer

Lives with Family (Required)

English Proficiency (Required)

Other Language (Required)

Other Language Proficiency (Required)

Highest Grade Completed (Required)

Employment Status (Required)

Child's Relationship (Required)

Custody (Required)

Provides Financial Support (Required)

Teen Parent (Required)

If Teen Parent, Subsidized? (Required)

Are there other adults in the household?

Add Another Adult

Please complete all fields. For this application, “family” includes all persons living in the same household who are supported by the child’s parent or guardian (and do not support themselves) and who are: Related to the child’s parent/Legal guardian by blood, marriage, or adoption; or the child’s authorized caregiver or legally responsible party, as documented by a court. Providing false or misleading information about household members may result in legal action.

Number of Parents/Guardians

Relationship to Participant(s)

Primary Language at Home

Is another language being acquired or learned at home?

Number in Household

Number in Family

Gross Annual Income

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

Is your family receiving Supplemental Security Income (SSI)?

Is your family receiving services from WIC?

WIC ID (if applicable)

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

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

Please answer all questions for the applying child. Use the child’s name exactly as it appears on their proof of birth. If you have already completed an application with Head Start please contact ERSEA Coordinator at 407-836-7602

First Name (Required)

Middle Name (Required)

Last Name (Required)

Suffix

Nickname

Birthday (Required)

Gender (Required)

Race and/or Ethnicity - To specify multiracial and/or multiethnic please check all races and/or ethnicities that apply (Required)

American Indian or Alaska Native

Asian

Black or African American

Hispanic or Latino

Middle Eastern or North African

Native Hawaiian or Pacific Islander

White

Prefer not to answer

Lives with Family (Required)

English Proficiency (Required)

Other Language (Required)

Other Language Proficiency (Required)

Primary Health Coverage (Required)

Other Coverage (Required)

Insurance Number (Required)

Medicaid Eligibility (Required)

Medicaid Number (Required)

Doctor/Medical Home (Required)

Dental Coverage (Required)

Dental Coverage Number (Required)

Dentist/Dental Home (Required)

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

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

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

Certification: I certify that the information provided is true and accurate to the best of my knowledge. I understand that if any part of this information is found to be false, my participation in the agency’s programs may be terminated, and I may be subject to legal action. I also understand that the information contained in this application will be kept strictly confidential within the agency and will be accessible to me during normal business hours. I further understand that contact will be made within the next 72 hours regarding this application. Thank you for your interest in the Head Start Program. Please click Submit to finalize your request. A member of our team will contact you by phone to schedule an intake appointment. If you are not contacted within 30 calendar days, please contact ERSEA Coordinator, Hope Massey at 407-836-7602 or Program Manager, Colette Thomas at 407-836-6546.

Required information is missing, see above.

Parent/Guardian

Address

Additional Parent/Guardian

Other Adults

Family Information

Emergency Contacts

Child (Applicant)

Location Preferences

Additional Applicant

Siblings