Apply Online

2/15/2024 4:17 PM Angela Lowery Director 2/6/2024 12:20 PM Angela Lowery Director This family pre-application is only an interest application for Head Start or Early Head Start. Once completed a Family Services Staff will review and contact you to complete an application and turn in the following documentation for eligibility: Verification of income, SSI, TANF or SNAP, Birth Certificate, Immunization Forms 121 or Form 122 and Insurance Verification. Other documentation maybe required depending on the Program. Things that are important when completing the interest pre-application. a. Children applying for Head Start must be 3 years old by September 1st of the applying year. b. Children applying for Early Head Start must be 8 weeks old or have had their first set of immunizations. c. Select the Correct Program. d. If you do not see the Program, look for other programs. e. Enter your names in CAPITAL LETTERS. f. Enter your 1st choice location. g. If you select a 2nd location do not list the same as your 1st location. h. Please make sure phone numbers, email address and home address are correct. i. If you previously completed an online pre-application, you will not be able to enter another one. Contact your local Head Start Center.

Please chose the center closest to where your child lives. The child must be a MS child. Contact your local Head Start Center Family Services if you are unsure of the center to select. For Blended partner location please apply directly with the school or day care location.

First Name (Required)

Middle Name

Last Name (Required)

Suffix

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

Other Language Proficiency

Highest Grade Completed

Employment Status

Child's Relationship

Custody

Lives with Family

Provides Financial Support

Teen Parent

If Teen Parent, Subsidized?

Please list a telephone number and an email address. You may be sent text messages. If your child is selected/accepted (you will get a notice) be sure to sign-up for Remind 101 to receive messages from the center.

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

Is there another parent/guardian in the family?

First Name (Required)

Middle Name

Last Name (Required)

Suffix

Birthday (Required)

Gender

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

Custody

Lives with Family

Provides Financial Support

Teen Parent

Please list a telephone number and an email address.

Number of Parents/Guardians

Relationship to Participant(s)

Primary Language at Home

Is another language being acquired or learned at home?

Number in Household

Number in Family

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

Race

Hispanic

Other Language

Other Language Proficiency

Primary Health Coverage

Other Coverage

Insurance Number

Medicaid Eligibility

Medicaid Number

Doctor/Medical Home

Dental Coverage

Dentist/Dental Home

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)

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

Are there other children in the family?

Add a Sibling

2/15/2024 4:17 PM Angela Lowery Director 2/15/2024 4:17 PM Angela Lowery Director 2/15/2024 4:16 PM Angela Lowery Director 2/6/2024 12:22 PM Angela Lowery Director Thank you for your interest in ICS Head Start or Early Head Start. If you completed your pre-application during summer our local centers are closed and Central Office open Monday - Thursday. Center locations and addresses/phone numbers are on the ICS web-site at ics-hs.org. We truly hope that we can serve you and your family and help make small miracles a great success.

Required information is missing, see above.

Parent/Guardian

Address

Additional Parent/Guardian

Family Information

Emergency Contacts

Child (Applicant)

Location Preferences

Additional Applicant

Siblings