You are now applying for the 2025-26 school year HEAD START - EARLY HEAD START Preschool ONLY. Please fill out this application completely. After submitting the online application, you will be directed to upload documents and then schedule an appointment with a Family Advocate to determine eligibility. Please use correct spelling of names according to what is on official documents, i.e. birth certificate. When entering your information please do not use all capital letters.
Parent/Guardian
Please fill in the following information for the primary adult contact of the family who has custody/guardianship of the child.
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 (Required)
Opt In for Text Messages
Yes
No
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
American Indian or Alaska Native
Asian
Black or African American
Multi-racial/Biracial
Native Hawaiian/Other Pacific Islander
Other
Unspecified
White
Hispanic
Yes
No
Lives with Family (Required)
Yes
No
English Proficiency (Required)
Little
Moderate
None
Proficient
Other Language
Achinese
Achioli
African (Swahill, Wolof)
Akan
Albanian
American Sign Language
Amharic
Apache
Arabic
Arapaho
Armenian
Assyrian Neo-Aramaic
Aymara
Azerbaijani
Baluchi
Basque
Bengali
Bikol
Bisaya
Bosnian
Bulgarian
Buriat
Burmese
Cambodian (Khmer)
Caribbean (Haitian-Creole, Patois)
Cebuano
Chamorro
Cherokee
Cheyenne
Chickasaw
Chinese
Chinese--Cantonese
Chinese--Mandarin
Chippewa
Choctaw
Chuukese (Trukese)
Comanche
Cree
Creole-English
Creole-French
Creole-Portuguese Based
Croatian
Crow
Cushtic
Czech
Dakota
Danish
Delaware
Dinka
Dogri
Dutch
East Asian (Chinese, Vietnamese, Tagalog)
English
Eskimo-Alueut
European & Slavic (German,French,Italian,Croatian,Yiddish, Portuguese, Russian)
Farsi (Eastern-Dari)
Farsi (Western-Persian)
Fijian
Filipino (Pilipino)
Finnish
French
Fulah
Ga-Runkuwa
Gbaya (Cent. African Republic)
Georgian
German
Gokana
GONDI
Goshute
Grebo
Greek
Guarani
Gujarati
Haida
Haitian
Hausa
Havasupai-Walapai-Yavapai
Hawaiian
Hebrew
Hindi
Hmong
Hopi
Hungarian
Iban
Icelandic
Igbo (Ibo)
Indonesian
Inuktitut
Inupiaq
Italian
Japanese
Judeo-Arabic
Kakwa
Kannada
Kanuri
Karen
Kazakh
Komi
Kongo
Konkani
Korean
Kosraean
Kpelle
Krahn
Kru
Kurdish
Lahnda
Lakota
Lao (Laotian)
Latvian
Lingala
Lithuanian
Lozi
Luganda
Maay (Maymay, Rahanween)
Mabaan
Macedonian
Madi
Malagasy
Malay
Malayalam
Mandingo
Maori
Marathi
Mari (Russia)
Marshallese
Marwari
Middle Eastern, South Asian (Arabic, Hebrew, Hindi, Urdu, Bengali)
Mongolian
Mongolian
Montenegrin
Mortlockese
Mushungulu
Native American Indian (not specified)
Native Central, South American & Mexican Languages(e.g. Mixtco)
Native North American/Alaska Native
Navajo
Nepali
Ngambay
Norwegian
Nubian
Nuer
Nukuoro
Ojibwa
Oromo
Pacific Island (Palauan, Fijian)
Paiute
Paiute-Northern
Palauan
Papiamento
Pashto-Northern
Pashto-Southern
Persian
Pingelapese
Pohnpeian
Polish
Portuguese
Punjabi
Pushto
Quechua
Quiche Central
Rajasthani
Romanian
Romany
Ronga
Rundi (Kirundi, Urundi)
Russian
Samoan
Sardinian
Serbian
Sherpa
Shona
Shoshoni
Sindi
Sinhala (Sinhalese)
Siouan (Sioux)
Slave (Athapascan)
Slovak
Slovenian
Somali
Spanish
Spanish
Swahili
Swedish
Swiss (German)
Syriac
Tagalog
Tahitian
Tamashek
Tamil
Teluga
Thai
Tibetan
Tigrina (Tigrinya)
Tohono O'Odham (Papago)
Tok Pisin
Tongan
Turkish
Turkmen
Uduk (Twampa)
Ukranian
Unspecified
Urdu
Ute-Southern Paiute
Uzbek
Vai
Vietnamese
Welsh
Wolof (Gambian)
Yapese
Yiddish
Yoruba
Zapotec
Zaza
Zhuang
Zulu
Zuni
Other Language Proficiency
Little
Moderate
None
Proficient
Highest Grade Completed (Required)
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 (Required)
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 (Required)
Biological/Adopted/Step
Foster
Grandchild
Other
Other Relative
Custody (Required)
Yes
No
Address
Please fill this section out for the child's primary location of residence.
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 (Required)
Address Line 2
City (Required)
State (Required)
ZIP (Required)
Additional Parent/Guardian
Please fill in the following information for the secondary adult contact of the family who has custody/guardianship of the child.
Is there another parent/guardian in the family?
Yes
No
First Name (Required)
Middle Name
Last Name (Required)
Birthday (Required)
Gender
Female
Male
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
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
Lives with Family (Required)
Yes
No
English Proficiency
Little
Moderate
None
Proficient
Other Language
Achinese
Achioli
African (Swahill, Wolof)
Akan
Albanian
American Sign Language
Amharic
Apache
Arabic
Arapaho
Armenian
Assyrian Neo-Aramaic
Aymara
Azerbaijani
Baluchi
Basque
Bengali
Bikol
Bisaya
Bosnian
Bulgarian
Buriat
Burmese
Cambodian (Khmer)
Caribbean (Haitian-Creole, Patois)
Cebuano
Chamorro
Cherokee
Cheyenne
Chickasaw
Chinese
Chinese--Cantonese
Chinese--Mandarin
Chippewa
Choctaw
Chuukese (Trukese)
Comanche
Cree
Creole-English
Creole-French
Creole-Portuguese Based
Croatian
Crow
Cushtic
Czech
Dakota
Danish
Delaware
Dinka
Dogri
Dutch
East Asian (Chinese, Vietnamese, Tagalog)
English
Eskimo-Alueut
European & Slavic (German,French,Italian,Croatian,Yiddish, Portuguese, Russian)
Farsi (Eastern-Dari)
Farsi (Western-Persian)
Fijian
Filipino (Pilipino)
Finnish
French
Fulah
Ga-Runkuwa
Gbaya (Cent. African Republic)
Georgian
German
Gokana
GONDI
Goshute
Grebo
Greek
Guarani
Gujarati
Haida
Haitian
Hausa
Havasupai-Walapai-Yavapai
Hawaiian
Hebrew
Hindi
Hmong
Hopi
Hungarian
Iban
Icelandic
Igbo (Ibo)
Indonesian
Inuktitut
Inupiaq
Italian
Japanese
Judeo-Arabic
Kakwa
Kannada
Kanuri
Karen
Kazakh
Komi
Kongo
Konkani
Korean
Kosraean
Kpelle
Krahn
Kru
Kurdish
Lahnda
Lakota
Lao (Laotian)
Latvian
Lingala
Lithuanian
Lozi
Luganda
Maay (Maymay, Rahanween)
Mabaan
Macedonian
Madi
Malagasy
Malay
Malayalam
Mandingo
Maori
Marathi
Mari (Russia)
Marshallese
Marwari
Middle Eastern, South Asian (Arabic, Hebrew, Hindi, Urdu, Bengali)
Mongolian
Mongolian
Montenegrin
Mortlockese
Mushungulu
Native American Indian (not specified)
Native Central, South American & Mexican Languages(e.g. Mixtco)
Native North American/Alaska Native
Navajo
Nepali
Ngambay
Norwegian
Nubian
Nuer
Nukuoro
Ojibwa
Oromo
Pacific Island (Palauan, Fijian)
Paiute
Paiute-Northern
Palauan
Papiamento
Pashto-Northern
Pashto-Southern
Persian
Pingelapese
Pohnpeian
Polish
Portuguese
Punjabi
Pushto
Quechua
Quiche Central
Rajasthani
Romanian
Romany
Ronga
Rundi (Kirundi, Urundi)
Russian
Samoan
Sardinian
Serbian
Sherpa
Shona
Shoshoni
Sindi
Sinhala (Sinhalese)
Siouan (Sioux)
Slave (Athapascan)
Slovak
Slovenian
Somali
Spanish
Spanish
Swahili
Swedish
Swiss (German)
Syriac
Tagalog
Tahitian
Tamashek
Tamil
Teluga
Thai
Tibetan
Tigrina (Tigrinya)
Tohono O'Odham (Papago)
Tok Pisin
Tongan
Turkish
Turkmen
Uduk (Twampa)
Ukranian
Unspecified
Urdu
Ute-Southern Paiute
Uzbek
Vai
Vietnamese
Welsh
Wolof (Gambian)
Yapese
Yiddish
Yoruba
Zapotec
Zaza
Zhuang
Zulu
Zuni
Other Language Proficiency
Little
Moderate
None
Proficient
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 (Required)
Biological/Adopted/Step
Foster
Grandchild
Other
Other Relative
Custody (Required)
Yes
No
Family Information
Please refer to the following when answering questions in this section: Number in Family = Number of people supported by household income, and related to the applicant by blood, marriage, and/or adoption. Gross Annual Income = This can be an estimate, however, proof of actual income will be required.
Number of Parents/Guardians (Required)
One Parent Family
Two Parent Family
Relationship to Participant(s) (Required)
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 (Required)
Achinese
Achioli
African (Swahill, Wolof)
Akan
Albanian
American Sign Language
Amharic
Apache
Arabic
Arapaho
Armenian
Assyrian Neo-Aramaic
Aymara
Azerbaijani
Baluchi
Basque
Bengali
Bikol
Bisaya
Bosnian
Bulgarian
Buriat
Burmese
Cambodian (Khmer)
Caribbean (Haitian-Creole, Patois)
Cebuano
Chamorro
Cherokee
Cheyenne
Chickasaw
Chinese
Chinese--Cantonese
Chinese--Mandarin
Chippewa
Choctaw
Chuukese (Trukese)
Comanche
Cree
Creole-English
Creole-French
Creole-Portuguese Based
Croatian
Crow
Cushtic
Czech
Dakota
Danish
Delaware
Dinka
Dogri
Dutch
East Asian (Chinese, Vietnamese, Tagalog)
English
Eskimo-Alueut
European & Slavic (German,French,Italian,Croatian,Yiddish, Portuguese, Russian)
Farsi (Eastern-Dari)
Farsi (Western-Persian)
Fijian
Filipino (Pilipino)
Finnish
French
Fulah
Ga-Runkuwa
Gbaya (Cent. African Republic)
Georgian
German
Gokana
GONDI
Goshute
Grebo
Greek
Guarani
Gujarati
Haida
Haitian
Hausa
Havasupai-Walapai-Yavapai
Hawaiian
Hebrew
Hindi
Hmong
Hopi
Hungarian
Iban
Icelandic
Igbo (Ibo)
Indonesian
Inuktitut
Inupiaq
Italian
Japanese
Judeo-Arabic
Kakwa
Kannada
Kanuri
Karen
Kazakh
Komi
Kongo
Konkani
Korean
Kosraean
Kpelle
Krahn
Kru
Kurdish
Lahnda
Lakota
Lao (Laotian)
Latvian
Lingala
Lithuanian
Lozi
Luganda
Maay (Maymay, Rahanween)
Mabaan
Macedonian
Madi
Malagasy
Malay
Malayalam
Mandingo
Maori
Marathi
Mari (Russia)
Marshallese
Marwari
Middle Eastern, South Asian (Arabic, Hebrew, Hindi, Urdu, Bengali)
Mongolian
Mongolian
Montenegrin
Mortlockese
Mushungulu
Native American Indian (not specified)
Native Central, South American & Mexican Languages(e.g. Mixtco)
Native North American/Alaska Native
Navajo
Nepali
Ngambay
Norwegian
Nubian
Nuer
Nukuoro
Ojibwa
Oromo
Pacific Island (Palauan, Fijian)
Paiute
Paiute-Northern
Palauan
Papiamento
Pashto-Northern
Pashto-Southern
Persian
Pingelapese
Pohnpeian
Polish
Portuguese
Punjabi
Pushto
Quechua
Quiche Central
Rajasthani
Romanian
Romany
Ronga
Rundi (Kirundi, Urundi)
Russian
Samoan
Sardinian
Serbian
Sherpa
Shona
Shoshoni
Sindi
Sinhala (Sinhalese)
Siouan (Sioux)
Slave (Athapascan)
Slovak
Slovenian
Somali
Spanish
Spanish
Swahili
Swedish
Swiss (German)
Syriac
Tagalog
Tahitian
Tamashek
Tamil
Teluga
Thai
Tibetan
Tigrina (Tigrinya)
Tohono O'Odham (Papago)
Tok Pisin
Tongan
Turkish
Turkmen
Uduk (Twampa)
Ukranian
Unspecified
Urdu
Ute-Southern Paiute
Uzbek
Vai
Vietnamese
Welsh
Wolof (Gambian)
Yapese
Yiddish
Yoruba
Zapotec
Zaza
Zhuang
Zulu
Zuni
Is another language being acquired or learned at home?
Yes
No
Number in Family (Required)
Gross Annual Income (Required)
Is your family receiving cash benefits or other services under the Temporary Assistance for Needy Families (TANF) program? (Required)
Yes
No
Is your family receiving Supplemental Security Income (SSI)? (Required)
Yes
No
Is your family receiving services from WIC? (Required)
Yes
No
Is your family receiving services under the Supplemental Nutrition Assistance Program (SNAP), formerly referred to as Food Stamps? (Required)
Yes
No
Is at least one parent/guardian an active duty member of the United States military? (Required)
Yes
No
Is at least one parent/guardian a veteran of the United States military? (Required)
Yes
No
Emergency Contacts
Add Emergency Contact
Child (Applicant)
Please completely fill out the following information for the child you are applying for.
First Name (Required)
Middle Name
Last Name (Required)
Birthday (Required)
Gender (Required)
Female
Male
Race (Required)
American Indian or Alaska Native
Asian
Black or African American
Multi-racial/Biracial
Native Hawaiian/Other Pacific Islander
Other
Unspecified
White
Hispanic (Required)
Yes
No
Lives with Family (Required)
Yes
No
English Proficiency (Required)
Little
Moderate
None
Proficient
Other Language
Achinese
Achioli
African (Swahill, Wolof)
Akan
Albanian
American Sign Language
Amharic
Apache
Arabic
Arapaho
Armenian
Assyrian Neo-Aramaic
Aymara
Azerbaijani
Baluchi
Basque
Bengali
Bikol
Bisaya
Bosnian
Bulgarian
Buriat
Burmese
Cambodian (Khmer)
Caribbean (Haitian-Creole, Patois)
Cebuano
Chamorro
Cherokee
Cheyenne
Chickasaw
Chinese
Chinese--Cantonese
Chinese--Mandarin
Chippewa
Choctaw
Chuukese (Trukese)
Comanche
Cree
Creole-English
Creole-French
Creole-Portuguese Based
Croatian
Crow
Cushtic
Czech
Dakota
Danish
Delaware
Dinka
Dogri
Dutch
East Asian (Chinese, Vietnamese, Tagalog)
English
Eskimo-Alueut
European & Slavic (German,French,Italian,Croatian,Yiddish, Portuguese, Russian)
Farsi (Eastern-Dari)
Farsi (Western-Persian)
Fijian
Filipino (Pilipino)
Finnish
French
Fulah
Ga-Runkuwa
Gbaya (Cent. African Republic)
Georgian
German
Gokana
GONDI
Goshute
Grebo
Greek
Guarani
Gujarati
Haida
Haitian
Hausa
Havasupai-Walapai-Yavapai
Hawaiian
Hebrew
Hindi
Hmong
Hopi
Hungarian
Iban
Icelandic
Igbo (Ibo)
Indonesian
Inuktitut
Inupiaq
Italian
Japanese
Judeo-Arabic
Kakwa
Kannada
Kanuri
Karen
Kazakh
Komi
Kongo
Konkani
Korean
Kosraean
Kpelle
Krahn
Kru
Kurdish
Lahnda
Lakota
Lao (Laotian)
Latvian
Lingala
Lithuanian
Lozi
Luganda
Maay (Maymay, Rahanween)
Mabaan
Macedonian
Madi
Malagasy
Malay
Malayalam
Mandingo
Maori
Marathi
Mari (Russia)
Marshallese
Marwari
Middle Eastern, South Asian (Arabic, Hebrew, Hindi, Urdu, Bengali)
Mongolian
Mongolian
Montenegrin
Mortlockese
Mushungulu
Native American Indian (not specified)
Native Central, South American & Mexican Languages(e.g. Mixtco)
Native North American/Alaska Native
Navajo
Nepali
Ngambay
Norwegian
Nubian
Nuer
Nukuoro
Ojibwa
Oromo
Pacific Island (Palauan, Fijian)
Paiute
Paiute-Northern
Palauan
Papiamento
Pashto-Northern
Pashto-Southern
Persian
Pingelapese
Pohnpeian
Polish
Portuguese
Punjabi
Pushto
Quechua
Quiche Central
Rajasthani
Romanian
Romany
Ronga
Rundi (Kirundi, Urundi)
Russian
Samoan
Sardinian
Serbian
Sherpa
Shona
Shoshoni
Sindi
Sinhala (Sinhalese)
Siouan (Sioux)
Slave (Athapascan)
Slovak
Slovenian
Somali
Spanish
Spanish
Swahili
Swedish
Swiss (German)
Syriac
Tagalog
Tahitian
Tamashek
Tamil
Teluga
Thai
Tibetan
Tigrina (Tigrinya)
Tohono O'Odham (Papago)
Tok Pisin
Tongan
Turkish
Turkmen
Uduk (Twampa)
Ukranian
Unspecified
Urdu
Ute-Southern Paiute
Uzbek
Vai
Vietnamese
Welsh
Wolof (Gambian)
Yapese
Yiddish
Yoruba
Zapotec
Zaza
Zhuang
Zulu
Zuni
Other Language Proficiency
Little
Moderate
None
Proficient
Location Preferences
Which program are you applying for? (Required)
Head Start
3 to 4 years old by September 1, 2025
Early Head Start
Birth to 2 years old by September 1, 2025
Location Preference
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1st Location Preference
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2nd Location Preference
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3rd Location Preference
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- 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
Thank you for applying. Please follow instructions, after you submit application, upload documents, and schedule your appointment. You will be required to provide proof of household income, proof of child's age, and child's current immunizations, which you can upload after you submit your application. Please feel free to contact the Family Enrichment Center at 801-402-0650 or fecregistration@dsdmail.net if you have any questions.
Required information is missing, see above.