Please complete the SER Jobs for Progress National - Early Head Start application with as much information as possible. A SER-Early Head Start staff member will be contacting you to verify the information submitted and request supporting documentation. Please begin gathering the following documents in order to finish the application process: * Child’s birth certificate or other proof of child age, social security card, immunization records, and medical insurance * Proof of income * Proof of residence --Proof of address
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.
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
Vietnamese
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
Family Information
For TANF, SSI. Yes
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
Vietnamese
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
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
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
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 Number
Doctor/Medical Home
929 N Galloway Ave Ste 121
A Ahmad
A.Jafarian M.D.
Abitoye, Omolara, MD
Acclaim Pediatrics
Acosta, Veronica MD
Adami, Bernard F. MD
Alayande, Aramide D. MD
Ali, Ashmead MD
Alma Medina, MD
Anglas, Pablo H. MD
Anne Ewert
Ariyo, Sarah MD
Arlington Neighborhood Clinic
Arlington Pediatric Partners PLL
Armando J. De Fex
Aruajo, Karla
Avenna Healthcare
Bailee Goddard-Hymas, AUD
Baylor Scott and White
Berg, Alan G., DO
Bernardez-Tan, Ruth A. MD
Bianca Venecia
Bright Star Pediatrics
Buckner Elam Medical
Burgos-Orta, Laura MD
Canh, Minh-Y, DO
Carrizales, Eva MD
Catholic Charities Dallas
Caturay, Epifania M. MD
Chandler Pediatric
Chavda, Chaitanya MD
Chen, Tom
Cherry Health
Children's health ped group
Children's Health Ped. Group
Children's Health Pediatric Gp
Childrens Health Primary Care De
Childrens Pediatric Group
Childrens' Legacy Endocrinology
ChildrensHealth
Claudia Phen
Clinicas Mi Doctor #13
Colberg, Eitel MD
Compassion Care Clinic
Comprehensive Pediatric Care
Cook Childrens Clinic
Curry, C. Daryl MD
Dallas Center ECI
Dallas County Health Department
Dallas Healthcare for Children
Deacon, Thomas E. MD
DeAnna McCall
Deharo-Saldivar Health Center
DeMasi, Melissa NP
Dosu, Babatunde MD,FAAP
Dr Agboola Fatiregun
Dr Martin Gomez
Dr Ruth Greer
Dr. A. ahmed
Dr. Ayesha Anwar
Dr. emily Sloan
Dr. Ewe G. Goh Pediatrics
Dr. Fatma Allam
Dr. Golden
Dr. Jyoti Jain
Dr. Marilyn Janke
Dr. Suteuvala
Dr. Vo
Dr. Zanida Iqbal
Duncanville Chidren's Pediatric
Dunlap, Heather
Durso, Barbara L. MD
Ewe Ghee Goh M.D P.A.
Excel Family Medicine
Family Medical Clinic of NDallas
Genesis Primecare
Ghadir Issa, MD
GPISD David Daniels
Grand Prairie School District Nu
Greif, Jules MD
Guimont, Sheree Marie MD
Hatcher Station Pediatrics
Head Start of Greater Dallas
Healing Hands Ministries
Health Care Clinics
Health Now Family Practice
Healthy Texan Pediatrics and Fam
Heeten Masters, D.O.
Heyne, Roy J.
Hopkins, Erio E. MD
Huang, Hsien-Hui MD
Irving Health Center
Isla Dental
Janai Okorodudu, MD
Johnson, Lara MD
JPS Ferguson SBC
JPS Southeast CHC
Julio E. Len, MD
Kallur, Triveni MD
karen Pilgram-King
Kashif Anwar Pediatrics
Kashif, Answar
Kennedy, James MD
Kids Doctor Pediatric
Kids Wellness Center
Kids Wellness Center of Sunnyval
Koehler, Bruce E. MD
Kreisler, Aaron MD
Lab Corp
Lalwani, Mansi MD
Lane, Cynthia RN
LBU Health Center
Leon, Alberto MD
Leon, Walter
Leon, Walter MD
Lin, Constance PNP
Longshaw, Jackie MD
Los Barrios Unidos
Lovering, Amanda M. AU.D.
MacArthur Pediatric
MacArthur Pediatrics
Mai Tran
Mansfield Pediatrics
MD Family #38
MD Family Clinic
MD Family Clinic-039
MD Kids
MD Kids
MD Kids Pediatric North Cockrell
MD Kids Pediatrics
MD Kids Pediatrics
MD Kids Pleasant Grove
Medical & Surgical Clinic Irving
Medical & Surgical Clinic Irving
Medical City
Medical City Arlington
Medico MD
Medicure Family Clinic
Mesquite Childrens Clinic
Methodist Health
MetroCareServices
Metroplex Pediatrics
Mi Doctor
Mi Doctor
Moshiree Thomas, Banafsheh MD
Mustafa Sutevala
My Childrens Clinic
Nancy M. Yeo, D.O.
Nellum, Connie ND
Nguyen, Stephanie MD
Nunez-Muniz, Ernesto A. MD
Oak Cliff Children's Clinic
Oak Crest Health Center
Oak West Pediatrics
Old Town Pediatrics
Onyirioha, Karen MD
Oortia Stephens
P. Malviya
Parkland Health & Hospital Syste
Parkland Health First
Patient Place
Patients Choice
Payne, Norris MD
Pediatric and Adolescent Center
Pediatric Center of Grand Prairi
Pediatric Center of Las Colinas
Pediatric Clinic of Garland
Pediatric Clinic of Mesquite
Pediatric Clinic of Sunnyvale
Pediatrix Medical GP/Sarah Comer
PEMR PGR Pediatrics
Pflieger, Kurt A. MD
PH&HS Homes Program
Piantini-Alvarez Rebeca, MD
Pioneer Family Doctor
Powell, Susan MD
Rainbow Children's Clinic
Rainbow Clinic
Rainbow Pediatrics Of Dallas
Rannulu, Sudath MD
Rebeca Piantini
Roberts, Gwenita MD
Rodriguez, Joselita MD
Rogers, Donza MD
Saleem, Mariam MD
Salizar, Angel MD
Satish Goel, MD
Schorlemer, Roger O. MD
Sejour, Jeanette MD
SER Jobs for Progress National
Shepherds Gate Life Changing
Siddipeta, Rama MD
Southeast Dallas Health Center
Speech Therapist Dallas
Sudath Rannulu M.D.
superior care clininc
Tammi Williams,MD
Texas Physicians Primary Care
The Council on Alcohol & Drug Ab
Tomecko, Shannon W. MD
TRAYSE ROBINSON
Triveni Kallur, MD
Tx Health and Human Services
Urrutia, Ricardo MD
Velez, Eduardo MD
Walter Love
Waymon Drummond M.D.
Weakley, David R. MD
Wee Tots Pediatrics
WIC Program Douna Preston
Dental Coverage
Children's Health Insurance Program (CHIP)
Combined Medicaid/CHIP
Medicaid
No Insurance
Other
Private Health Insurance
State-Only Funded Insurance
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)
EHS-CCP 2022-2023
1st Location Preference
<p></p>
2nd Location Preference
<p></p>
- 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 SER-Jobs for Progress National Early Head Start Program. Please click the "I am not a Robot" and "Submit Application" buttons to complete your application.
Required information is missing, see above.