Apply Online

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

First Name (Required)

Middle Name

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

Hispanic

English Proficiency

Other Language

Highest Grade Completed

Employment Status

Child's Relationship

Custody

Lives with Family

Provides Financial Support

Teen Parent

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

For TANF, SSI. Yes

Number of Parents/Guardians

Relationship to Participant(s)

Primary Language at Home

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?

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

First Name (Required)

Middle Name

Last Name (Required)

Suffix

Birthday (Required)

Gender

SSN

Race

Hispanic

Primary Health Coverage

Other Coverage

Insurance Number

Medicaid Number

Doctor/Medical Home

Dental Coverage

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)

1st Location Preference

2nd 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

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.

Parent/Guardian

Address

Family Information

Emergency Contacts

Child (Applicant)

Location Preferences

Additional Applicant

Siblings