Apply Online

Welcome to Head Start!! Darlington County Community Action Agency Head Start does require an email address for each family participating in our programs. There are many free choices available, a popular choice is Gmail. 1. Please complete our application for Head Start (3-5 years old). 2. After entering information, click the “I’m not a robot” reCaptcha verification box. 3. Click the “Submit Application” button at the bottom of the page to submit your application.

Please complete the information below about the primary adult in your family (father, mother, or guardian/caregiver)

First Name (Required)

Middle Name

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

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.

SSN

Race

Hispanic

English Proficiency

Highest Grade Completed

Employment Status

Child's Relationship

Custody

Lives with Family

Provides Financial Support

Teen Parent

If Teen Parent, Subsidized?

Our service area consist of: Darlington County

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

Is there another parent/guardian in the family?

First Name (Required)

Middle Name

Last Name (Required)

Birthday (Required)

Gender

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.

SSN

Race

Hispanic

English Proficiency

Highest Grade Completed

Employment Status

Child's Relationship

Custody

Lives with Family

Provides Financial Support

Teen Parent

If Teen Parent, Subsidized?

Are there other adults in the household?

Add Another Adult

The office of Head Start defines Family for a child as: All persons living in the same home supported by the applicant's (parent/guardian) income And related to the (parent/guardian) by blood, marriage, or adoption; child's authorized care-giver or legal responsible party.

Number of Parents/Guardians

Relationship to Participant(s)

Primary Language at Home

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?

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 provide the information for the child needing Head Start services.

First Name (Required)

Middle Name

Last Name (Required)

Suffix

Nickname

Birthday (Required)

Gender

SSN

Race

Hispanic

English Proficiency

Primary Health Coverage

Other Coverage

Insurance Number

Medicaid Eligibility

Medicaid Number

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)

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 submitting your enrollment application. What Happens Next? 1. One of our Family Service Specialist will receive your submission and follow up with you. 2. Please provide needed documentation. 3. Please make sure you keep your interview appointment. Federal regulations require this interview. Things to Keep in Mind 1. Applicants are responsible to keep us updated if your contact information changes. We also rely on you to respond to our efforts to reach you. We will generally make 3 attempts to contact you and may need to move to the next applicant if we do not receive a response. 2. Completing the enrollment application does not guarantee eligibility or enrollment into our programs. Enrollment is based on slot availability and filled according to greatest need. 3. Our office are open Monday-Friday form 8:00am -4:00pm. Please call us at (843)-332-6593 Ext. 110.

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