Apply Online

Thank you for your interest in CAPLP Head Start. Please answer all of the questions and submit the application when done. If any member of your family has been in CAPLP Head Start Program in the past, you will not be able to complete this online application. The computer will not allow you to complete the application. if that happens, please contact Head Start for an alternate way to apply. You can call 218-512-1515 or email Chelsea at chelseab@caplp.org. Early Head Start- Pregnant moms and children up to age 3. Head Start Preschool - Ages 3 to 5 years old. Children Must be 3 years old by Sept. 1 to qualify for Head Start Preschool. Please see our agencies Tennessen Warning - https://drive.google.com/drive/u/1/home

First Name (Required)

Last Name (Required)

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)

Highest Grade Completed (Required)

Employment Status (Required)

Child's Relationship (Required)

Custody (Required)

Please enter your living address

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 (Required)

Address Line 2

City (Required)

State (Required)

ZIP (Required)

Is there another parent/guardian in the family?

First Name (Required)

Last Name (Required)

Birthday (Required)

Gender (Required)

Email Address

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)

Highest Grade Completed (Required)

Employment Status (Required)

Child's Relationship (Required)

Custody

Number of Parents/Guardians

Relationship to Participant(s)

Primary Language at Home (Required)

Is another language being acquired or learned at home?

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

Is your family receiving Supplemental Security Income (SSI)? (Required)

Is your family receiving services from WIC? (Required)

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

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?

Thank you for your interest in the Head Start Program. Please send all income from the past 12 months (tax return, W2, 1040 or if you are on SSI, SNAP or cash assistance, that documentation works as well) AND send a copy of your child's immunization records and your child's most recent Well Child Check to chelseab@caplp.org Thank You! -------------------------By submitting this online pre-application, you are consenting to the CAPLP data Privacy Rights: Your privacy is protected under federal and state law. CAPLP asks for personal and household information to determine your eligibility for available programs and services. Providing this information is voluntary, but without it CAPLP may be unable to provide assistance or may delay services. Your information may be used for eligibility determination, program planning, reporting, research, and compliance with federal and state regulations. CAPLP may also contact you by mail, email, or text with program updates. Your personal information will not be shared outside CAPLP without your written permission, except as allowed by law with authorized government agencies and partner organizations. Only authorized CAPLP staff will have access to your information. Records are kept for seven years or until required audits are complete. You may review and request corrections to your records at any time. Consent: I consent to CAPLP’s use of my (or my child’s) personal information, in accordance with CAPLP’s Confidentiality Policy, to determine eligibility for and provide services through CAPLP programs.

Parent/Guardian

Address

Additional Parent/Guardian

Other Adults

Family Information

Emergency Contacts

Child (Applicant)

Location Preferences

Additional Applicant

Siblings