NOTE: If you have previously applied for Early Education at CAPSLO or you are unsure if we have your family information still on file, Please Do Not use the online application, use one of the following phone numbers to begin the process to update your existing family information: 888-633-6747 (MSHS) or 888-315-6741. Please complete the following online interest form if you're interested in one of our programs. The form is not an actual application and you will be contacted to start the application process with one of our staff members.
Parent/Guardian
First Name (Required)
Middle Name
Last Name (Required)
Birthday (Required)
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.
Other Language
ALBANIAN
American Sign Language
AMHARIC
ARABIC
ARAMICK
BANGLA
CAMBODIAN
CANTONESE
CHALDEAN
CHATINO
CHINESE
CREE
DARI
DIALECTO
ELOCANO
English
FARSI
FRENCH
GERMAN
HAUSA
HINDU
IGBO
ITALIAN
JAPANESE
KALDIAN
KOREAN
KURDISH
LAO
LUGANDA
MANDARIN
MIXTECO
NAUAHTL
NEPALESE
OTHER
OTOMI
PASHTO
PERSIAN
PORTUGUESE
PUNJABI
PUREPECHA
RUSSIAN
SERBIAN
SINHALESE
SOMALI
Spanish
SWAHILI
TAGALOG
TARASCO
TELUGU
TRIQUE
TZEL TAL
UKRAINIAN
VIETNAMESE
ZAPOTECO
Other Language Proficiency
Little
Moderate
None
Proficient
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
Custody
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
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
ALBANIAN
American Sign Language
AMHARIC
ARABIC
ARAMICK
BANGLA
CAMBODIAN
CANTONESE
CHALDEAN
CHATINO
CHINESE
CREE
DARI
DIALECTO
ELOCANO
English
FARSI
FRENCH
GERMAN
HAUSA
HINDU
IGBO
ITALIAN
JAPANESE
KALDIAN
KOREAN
KURDISH
LAO
LUGANDA
MANDARIN
MIXTECO
NAUAHTL
NEPALESE
OTHER
OTOMI
PASHTO
PERSIAN
PORTUGUESE
PUNJABI
PUREPECHA
RUSSIAN
SERBIAN
SINHALESE
SOMALI
Spanish
SWAHILI
TAGALOG
TARASCO
TELUGU
TRIQUE
TZEL TAL
UKRAINIAN
VIETNAMESE
ZAPOTECO
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 under the Supplemental Nutrition Assistance Program (SNAP), formerly referred to as Food Stamps?
Yes
No
Child (Applicant)
First Name (Required)
Last Name (Required)
Birthday (Required)
Location Preferences
Which program are you applying for? (Required)
Early Education and Child Care
Head Start, Early Head Start, Migrant Head Start, State
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 completing the online interest form (this is not an application). You will be contacted to start the application process with one of our staff members. .
Required information is missing, see above.