Apply Online

Please complete the Pre-application for Head Start below.

If applying in person, please bring copies of:

Proof of Income (Tax Return/1040, W-2, SNAP, TANF, SSI)
Child’s Birth Certificate (Must be age eligible on or before 9/1)
Proof of Physical Address (We do not accept P.O. Box #s)
Proof of Guardianship (if applicable)

Parent/Legal Guardian who is enrolling child.

First Name (Required)

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.

Race (Required)

Hispanic (Required)

English Proficiency

Other Language (Required)

Other Language Proficiency

Highest Grade Completed (Required)

Employment Status (Required)

Child's Relationship (Required)

Custody

Lives with Family

Provides Financial Support

Please provide a physical address (no P.O. Boxes will be accepted).

The McKinney-Vento Act defines homeless children and youths as individuals who lack a fixed, regular, and adequate nighttime residence. This definition also includes: Children and youths who are sharing the housing of other persons due to loss of housing, economic hardship, or a similar reason.

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

The Secondary Adult/Legal Guardian that lives in the same household.

Is there another parent/guardian in the family?

First Name (Required)

Last Name (Required)

Suffix

Birthday (Required)

Gender

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

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.

Race (Required)

Hispanic (Required)

English Proficiency

Other Language (Required)

Other Language Proficiency

Highest Grade Completed (Required)

Employment Status (Required)

Child's Relationship (Required)

Custody

Lives with Family

Provides Financial Support

Are there other adults in the household?

Add Another Adult

Number of Parents/Guardians (Required)

Relationship to Participant(s)

Primary Language at Home (Required)

Is another language being acquired or learned at home? (Required)

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?

WIC ID (if applicable)

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

Information for the applying child

First Name (Required)

Middle Name

Last Name (Required)

Suffix

Birthday (Required)

Gender

Race (Required)

Hispanic (Required)

English Proficiency (Required)

Other Language (Required)

Other Language Proficiency

Primary Health 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

Required information is missing, see above.

Please complete the Pre-application for Head Start below.

If applying in person, please bring copies of:

Parent/Guardian

Parent/Legal Guardian who is enrolling child.

Address

Please provide a physical address (no P.O. Boxes will be accepted).

Additional Parent/Guardian

The Secondary Adult/Legal Guardian that lives in the same household.

Other Adults

Family Information

Emergency Contacts

Child (Applicant)

Information for the applying child

Location Preferences

Additional Applicant

Siblings