Welcome to C.E.F.S. Head Start 0-5 Program. Please complete our pre-application. If you have problems completing this application, please call 217-663-7822 and someone will contact you.
Parent/Guardian
First Name (Required)
Middle Name
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.
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.
Mailing Address same as Living Address
Mailing Address
Address Line 2
City
State
ZIP
Additional Parent/Guardian
Only list the second adult in the home if he/she is the biological parent/legal guardian or married to the biological parent to the applying child.
Is there another parent/guardian in the family?
Yes
No
First Name (Required)
Middle Name
Last Name (Required)
Birthday (Required)
Gender
Female
Male
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.
Family Information
Number of Parents/Guardians
One Parent Family
Two Parent Family
Relationship to Participant(s)
Foster parent(s) not including relatives
Grandparent(s)
Other
Parent(s) (e.g. biological, adoptive, stepparents)
Relative(s) other than grandparents
Primary Language at Home
American Sign Language
Arabic
Chinese
Dutch
English
Filipino
French
German
Gujarati
Indian
Indonesian
Japanese
Polish
Portugese
Punjabi
Sign Language
Sioux
Spanish
Tagalog
Thai
Vietnamese
Child (Applicant)
First Name (Required)
Middle Name
Last Name (Required)
Birthday (Required)
Gender
Female
Male
Location Preferences
Which program are you applying for? (Required)
Head Start
3-5 year old (Classroom)
Early Head Start
0-3 year old (Home Based)
1st Location Preference
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2nd 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
Siblings
Are there other children in the family?
Add a Sibling
Thank you for taking the time to fill out this pre-application. To complete this application we will need to verify your 2019 income or income from the last 12 months. Someone from our agency will contact you soon. If you have any questions, please call 217-663-7822.
Required information is missing, see above.