The Kiowa Tribe Head Start Program provides pre-school and comprehensive social services to eligible low-income 3, 4, and 5 year old children and their families at no cost. Children must be age eligible at the time you are applying. The Program requires a copy of all Eligibility Documents to be submitted before your child can be considered for enrollment. Documents can be sent via email to ssatepeahtaw@yahoo.com or taken to your local Kiowa Tribe Head Start Center. Required Documents include Child's Birth Certificate, Social Security Card, Insurance Verification, Certificate of Degree of Indian Blood (if applicable), Immunization Record, and Income Verification. Please provide along with the required documents a copy of your child's current Well Child Exam and Dental Exam. If you need assistance in completing the application or have any questions, please contact us at 580-654-6396 or toll free at 1-855-711-4010.
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.
SSN
Race
American Indian or Alaska Native
Asian
Black or African American
Multi-racial/Biracial
Native Hawaiian/Other Pacific Islander
Other
Unspecified
White
Hispanic
Yes
No
English Proficiency
Little
Moderate
None
Proficient
Other Language
American Sign Language
English
Spanish
Other Language Proficiency
Little
Moderate
None
Proficient
Highest Grade Completed
Associate's Degree
Bachelor's Degree
College Degree/Training Cert.
College or Advance Training
General Education Diploma
Grade 10
Grade 11
Grade 12
Grade 9 or less
High School Graduate
Master's Degree
Employment Status
Full-time & Training
Full-time (35 hours/week or more)
Part-time & Training
Part-time (Under 35 hours/week)
Retired or Disabled
Seasonally Employed
Training or School
Unemployed
Child's Relationship
Biological/Adopted/Step
Foster
Grandchild
Other
Other Relative
Custody
Yes
No
Lives with Family
Yes
No
Provides Financial Support
Yes
No
Teen Parent
Yes
No
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
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.
SSN
Race
American Indian or Alaska Native
Asian
Black or African American
Multi-racial/Biracial
Native Hawaiian/Other Pacific Islander
Other
Unspecified
White
Hispanic
Yes
No
English Proficiency
Little
Moderate
None
Proficient
Other Language
American Sign Language
English
Spanish
Other Language Proficiency
Little
Moderate
None
Proficient
Highest Grade Completed
Associate's Degree
Bachelor's Degree
College Degree/Training Cert.
College or Advance Training
General Education Diploma
Grade 10
Grade 11
Grade 12
Grade 9 or less
High School Graduate
Master's Degree
Employment Status
Full-time & Training
Full-time (35 hours/week or more)
Part-time & Training
Part-time (Under 35 hours/week)
Retired or Disabled
Seasonally Employed
Training or School
Unemployed
Child's Relationship
Biological/Adopted/Step
Foster
Grandchild
Other
Other Relative
Custody
Yes
No
Lives with Family
Yes
No
Provides Financial Support
Yes
No
Teen Parent
Yes
No
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
English
Spanish
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?
Yes
No
Is your family receiving Supplemental Security Income (SSI)?
Yes
No
Is your family receiving services from WIC?
Yes
No
WIC ID (if applicable)
Is your family receiving services under the Supplemental Nutrition Assistance Program (SNAP), formerly referred to as Food Stamps?
Yes
No
Is at least one parent/guardian an active duty member of the United States military?
Yes
No
Is at least one parent/guardian a veteran of the United States military?
Yes
No
Emergency Contacts
Add Emergency Contact
Child (Applicant)
First Name (Required)
Middle Name
Last Name (Required)
Suffix
Nickname
Birthday (Required)
Gender
Female
Male
SSN
Race
American Indian or Alaska Native
Asian
Black or African American
Multi-racial/Biracial
Native Hawaiian/Other Pacific Islander
Other
Unspecified
White
Hispanic
Yes
No
English Proficiency
Little
Moderate
None
Proficient
Other Language
American Sign Language
English
Spanish
Other Language Proficiency
Little
Moderate
None
Proficient
Primary Health Coverage
Children's Health Insurance Program (CHIP)
Combined Medicaid/CHIP
Medicaid
No Insurance
Other
Private Health Insurance
State-Only Funded Insurance
Other Coverage
Children's Health Insurance Program (CHIP)
Combined Medicaid/CHIP
Medicaid
No Insurance
Other
Private Health Insurance
State-Only Funded Insurance
Insurance Number
Medicaid Eligibility
Not Eligible
On Medicaid
Potentially Eligible
Medicaid Number
Doctor/Medical Home
A Place To Grow
Advanced Eye Care
Advanced Hearing Aids & Audio
Ajmeri
Allergy Ear Nose & Throat
Amber Jones
Amber Stocco
Amy Hannington
Anadarko IHS Health Clinic
Anadarko Public Schools
Apache Public Schools
Ashley Powell
Ashley's Pediatrics
Atuena Friese
Caddo Kiowa Center
Carnegie Indian Clinic
Carnegie Public Schools
Carnegie Tri-county Hospital
Cherokee Nation Health Center
Children's eye care
Claremore Indian Hospital
Clinton AllianceHealth
Clinton Indina Health Center
Cocheran Family Eye Care
Comanche Community Health
Comanche Nation Optometry
Complete Eye Care
Cynthia West
Dana Alexander
Darrell Hill
Dean McGee Eye Institute
Denny Torres, PA-C
Devon Muncy
Dr Anna Reed
Dr Barnes
Dr Belt
Dr Blake Badgett
Dr Bryans
Dr Caradona (IHS)
Dr Collazo
Dr Dina Bowen
Dr Doug Riddle
Dr Du Toit
Dr Folake
Dr Franklin Williams
Dr Freed
Dr Furguson
Dr Gomez
Dr Greenburg
Dr Hall
Dr Head
Dr Hobbs
Dr Jackson
Dr Kimberly Turnipseed
Dr Knapp
Dr Leal
Dr Legko
Dr Luz
Dr Martha Arambula
Dr McConnell
Dr McFarland
Dr Minda Roan
Dr Schaufele
Dr Singh
Dr Solaterrio
Dr Stanley Corley
Dr Stutzman
Dr Thomas Adkinson
Dr Timothy Fricker
Dr Troy Harden
Dr Umobuarie
Dr West
Dr White
Dr Winn
Dr. Angela Farmer
Dr. Ariel
Dr. Aryan Kadivar MD
Dr. Bay (I.H.S)
Dr. Bluth
Dr. Brenda Stutbman
Dr. Carter
Dr. Chris Swanson
Dr. Clift-Anadarko IHS
Dr. Cosby
Dr. Cotton Southwestern Primary
Dr. Diadara
Dr. Fey
Dr. Happy
Dr. Hill
Dr. Huser
Dr. Jamie Laughey
Dr. Jamie Laughy
Dr. Jon Long
Dr. Kadechuck
Dr. Karnik
Dr. Kegako
Dr. Lewis
Dr. Lindsey King
Dr. Lutz
Dr. Lwellen
Dr. Mason
Dr. Matthew Malony
Dr. Michelle Hensley
Dr. Muncy
Dr. Myra Joy Frantz
Dr. Paszkowiak
Dr. Raman
Dr. Suarez
Dr. Swales
Dr. Toit
Dr. Wilson
DUNCAN REGIONAL HOSPITAL
Elgin Community Health Clinic
Elgin Public Schools
Eye Care on Gore
Family Medical Clinic
Family Medicine Urgent Care
Five Oaks Medical
Fort Cobb-Broxton Public School
Francois J du Toit MD
Frontier Medical Home
Ft Cobb Clinic
Fulton EyeCare Center, PLLC
Gore Therapy Center Corp.
Grady Memorial Hospital
Great Plains
Hearts for Hearing
Helen Hill
IHS
INTEGRIS Family Care Central
Integris Family Care Yukon
Jackson County Ped clinic
Kids Eye Site
KIOWA COUNTY HEALTH DEPT.
Kristyn Hobbs
Laura Story
Lawton Community Health Center
Lawton Indian Hopital
Lawton Public Schools
Marion Newton
maritza roman md
Mark Evans
Marshall Huser Family Medicine
Michael Martine
Mt. View-Gotebo Public Schools
Muckleshoot Health and Wellness
Nekeda Hall
Ok State Dept Health/Weatherford
Oklahoma Hearing Center
OU Medical audio dept.
OU Physicians Family Medicine
OU Southwest Family
OU/Western Tech Center Dental Hy
Paul C Tisdal, O.D.
Paul Firth
Pediatric Associates
Pediatric ENT of Ok PLLC
Prevent Blindness
Renato Caballero
Reynold's Army Hospital
Reynolds Army Hospital
Samantha Jackson
Sooner Pediatrics
Sothern plains medical center
Southwestern Pediatrics
Thomason Medical Clinic
True Vision-Hobart
VARIETY CARE ANADARKO
Velury
Weatherford Eyecare Center
Yukon health center
Dental Coverage
Children's Health Insurance Program (CHIP)
Combined Medicaid/CHIP
Medicaid
No Insurance
Other
Private Health Insurance
State-Only Funded Insurance
Dental Coverage Number
Dentist/Dental Home
29th Street Dental,
Adventure Dental
Anadarko Dental Group
Anadarko IHS Dental
Bedlam Smiles
Charles Morin, DMD
Chickasha Dental
Claremore Indian Hospital
Clinton Indina Health Center
Delta Dental
Dental Depot
dental smiles
Dr Bhakta/family Dentistry
Dr Brackett
Dr Brian Stephens
Dr Chelenza
Dr Evans
Dr Guthrie
Dr Jackson
Dr Maria Anderson
Dr Miracle
Dr Valines
Dr Wells
Dr. Cameron
Dr. Farmer
Dr. Paul Thomas
Dr. Raudik
Dr. Todd Bridges
Dr. Wuse Cara
Family Dentistry
Gregg Family Dentistry
Hinton Dental
IHS
Jubilee Dental
Las Milpas Dentist
Lawton kids dentistry and braces
Liberty Dental
lifetime dental
Mobile Smiles
Muckleshoot Health and Wellness
My Dentist
Ocean Dental
Ok city dentistry
OU Children's Hospital
OU/Western Tech Center Dental Hy
Pediatric Dentistry of Ok
Reynold's Army Hospital
Smile Galaxy
Smile Zone
Smiling Faces
Weatherford Dental Care
Wuse H. Cara
Yukon Kids Dental
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)
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
Siblings
Are there other children in the family?
Add a Sibling
Thank you for your interest in the Head Start Program. Please click submit to finalize your application.
Required information is missing, see above.