Thank you for beginning your application to Head Start for the 2024-25 school year. Please complete the following information to begin the process and help us determine eligibility. Please remember you will also need to submit the following documents before we can determine your child's eligibility for Head Start:
*Income Verification (examples--2023 tax forms, W-2s, child support, 3 recent pay stubs, letter of employment, TANF, SNAP, and SSI),
*Child's Birth Certificate,
*Child's Social Security Card, and
*Parent/Guardian Photo ID.
These documents may be attached at the end of the online application, delivered to one of our Head Start sites, or emailed to:
Once we have received your application, we will contact you to set up an intake appointment. Please remember submitting all your documents early helps speed up the process.
Additional documents will be needed after eligibility is determined, but before a spot can be secure. These documents are listed at the end of the application.
Please fill in all applicable fields when completing the online application.
Please complete this information about the child's primary parent or guardian. If the primary adult is not listed on the birth certificate, please be prepared to provide documentation showing guardianship.
Please complete the following information about the child's primary place of residence. Please note that "homelessness" is defined as "lacking a fixed, regular, and adequate nighttime residence." This may include sharing housing, living in motels/hotels, living in shelters, or living somewhere not designed to be housing.
Click here to find a provider in your area.
Complete this section for the child's secondary parent or guardian.

Are there other adults in the household?

Add Another Adult
Please complete for the family unit the child resides with. You will also need to designate Contacts. Contacts should be adults that we can contact if we are unable to reach the primary and/or secondary parent/guardians. For each contact you will designate if they are an emergency contact and/or if your child may be released to them. Children may only be released from school or the bus to people listed on the contact list. Each child must have at least one contact, but ideally has a minimum of three. You will click the "Add Emergency Contact" button for each person.
Please complete this section for child planning to attend Head Start.
- 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 your interest in Head Start! Please read below and then hit submit when you are finished.

By submitting this document you are certifying that this information is true. If any part is false, your participation in the Head Start program may be terminated and you may be subject to legal action. All information in the application will be held in strict confidence within the agency and is accessible during normal business hours.

Remember, we will need copies of all proof of income, child's birth certificate, child's social security card, and parent/guardian id to determine your eligibility. Copies may be attached on the next screen, delivered to one of our Head Start sites, or emailed to
Please be sure to include parent and child's name on any documents you email or drop off.
If you have any questions, please call our office at 765-454-7082 from 8am-4pm, Monday thru Friday.
Thank you and we look forward to working with your family.
Required information is missing, see above.