Apply Online

You are now applying for the 2024-25 school year HEAD START - EARLY HEAD START - TITLE I Preschool. 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.

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

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

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

Hispanic

English Proficiency (Required)

Other Language

Other Language Proficiency

Highest Grade Completed

Employment Status

Child's Relationship (Required)

Custody (Required)

Lives with Family

Please fill this section out for the child's primary location of residence.

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.

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?

First Name (Required)

Middle Name

Last Name (Required)

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

Hispanic

English Proficiency

Other Language

Other Language Proficiency

Highest Grade Completed

Employment Status

Child's Relationship (Required)

Custody (Required)

Lives with Family (Required)

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)

Relationship to Participant(s) (Required)

Primary Language at Home (Required)

Is another language being acquired or learned at home?

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)

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? (Required)

Is at least one parent/guardian a veteran of the United States military? (Required)

Add Emergency Contact

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)

Race (Required)

Hispanic (Required)

English Proficiency (Required)

Other Language

Other Language Proficiency

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

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.

Parent/Guardian

Address

Additional Parent/Guardian

Family Information

Emergency Contacts

Child (Applicant)

Location Preferences

Additional Applicant