Please complete all information requested in this online process. Once completed, staff will follow-up to schedule an intake appointment to complete the application process. IF YOU HAVE PREVIOUSLY APPLIED FOR SERVICES, PLEASE DO NOT USE THE ONLINE PROCESS.
Parent/Guardian
First Name (Required)
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.
Child's Relationship
Biological/Adopted/Step
Foster
Grandchild
Other
Other Relative
Address
Is your family experiencing homelessness?
Yes
No
Living Address (Required)
Address Line 2
City (Required)
State (Required)
ZIP (Required)
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to find a provider in your area.
Mailing Address same as Living Address
Mailing Address
Address Line 2
City
State
ZIP
Additional Parent/Guardian
Is there another parent/guardian in the family?
Yes
No
First Name (Required)
Last Name (Required)
Birthday (Required)
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.
Child's Relationship
Biological/Adopted/Step
Foster
Grandchild
Other
Other Relative
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
African Language
American Sign Language
Caribbean Language
Central American, South American & Mexican
East Asia
English
European & Slavic
Middle Eastern & South Asian
North American & Alaskan Native
Other
Pacific Island
Spanish
Spanish
Number in Household
Number in Family
Child (Applicant)
First Name (Required)
Last Name (Required)
Birthday (Required)
Does your child have a disability or do you have any concerns about your child's development?
Yes
No
Location Preferences
Which program are you applying for? (Required)
Pre-K Head Start 2025-2026
Free Quality Pre-K for Children 4 yrs old by Sept 1 2025
Preschool Head Start 2025-2026
Free Quality Preschool for Children Ages 3 to 5
Early Head Start 2025-2026
Free Quality Childcare for Infants, Toddlers and Pregnant Women
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
Siblings
Are there other children in the family?
Add a Sibling
Thank you for completing our online process. Staff will follow-up to schedule an intake appointment to complete the application process.
Required information is missing, see above.