Thank you for your interest in Skagit/Islands Head Start. You are taking the first step to connecting your family with no-cost comprehensive, high quality, early learning services! If you have any questions about this application or need assistance please reach out to our Enrollment Manager via email at andrea.garner@skagit.edu or you may call or text 360-499-6431.
Parent/Guardian
Please complete and review all fields prior to submission. If your information changes prior to us contacting you please let our main office know.
First Name (Required)
Last Name (Required)
Nickname
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
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
Unspecified
White
Hispanic
Yes
No
English Proficiency
Little
Moderate
None
Proficient
Other Language
American Sign Language
Amharic
Arabic
Chinese
English
Filipino
French
German
Indonesian
Japanese
Khmer
Mandarin
Marshallese
Mixteco
Punjabi
Romanian
Russian
Spanish
Swinomish
Tagalog
Thai
Triqui
Ukranian
Vietnamese
Other Language Proficiency
Little
Moderate
None
Proficient
Highest Grade Completed
Associate's Degree
Bachelor/advanced degree
High school diploma or GED
Less than high school diploma
Vocational school/some college
Employment Status
Full-time (35 hours/week or more)
Part-time or seasonally
Retired or Disabled
Stay at home parent
Training or School
Unemployed
Child's Relationship
Biological/Adopted/Step
Foster
Grandchild
Other
Other Relative
Custody
Yes
No
Lives with Family
Yes
No
Address
Our program is only allowed to serve children/families who live in Skagit and Island county as well as Friday Harbor. If you do not live in our service area, we'd be happy to assist you in finding a program in your community.
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
Additional Parent/Guardian
Only adults who have custodial rights or guardianship over the child for whom you are applying for should be listed here. Please do not include live-in partners who do not have legal rights regarding the child.
Is there another parent/guardian in the family?
Yes
No
First Name (Required)
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
Unspecified
White
Hispanic
Yes
No
English Proficiency
Little
Moderate
None
Proficient
Other Language
American Sign Language
Amharic
Arabic
Chinese
English
Filipino
French
German
Indonesian
Japanese
Khmer
Mandarin
Marshallese
Mixteco
Punjabi
Romanian
Russian
Spanish
Swinomish
Tagalog
Thai
Triqui
Ukranian
Vietnamese
Other Language Proficiency
Little
Moderate
None
Proficient
Highest Grade Completed
Associate's Degree
Bachelor/advanced degree
High school diploma or GED
Less than high school diploma
Vocational school/some college
Employment Status
Full-time (35 hours/week or more)
Part-time or seasonally
Retired or Disabled
Stay at home parent
Training or School
Unemployed
Child's Relationship
Biological/Adopted/Step
Foster
Grandchild
Other
Other Relative
Custody
Yes
No
Lives with Family
Yes
No
Other Adults
Are there other adults in the household?
Add Another Adult
Family Information
Please tell us a little more about your family
Number of Parents/Guardians
One Parent Family
Two Parent Family
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
American Sign Language
Amharic
Arabic
Chinese
English
Filipino
French
German
Indonesian
Japanese
Khmer
Mandarin
Marshallese
Mixteco
Punjabi
Romanian
Russian
Spanish
Swinomish
Tagalog
Thai
Triqui
Ukranian
Vietnamese
Is another language being acquired or learned at home?
Yes
No
Number in Household
Number in Family
Gross Annual Income
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 from WIC?
Yes
No
Is your family receiving services under the Supplemental Nutrition Assistance Program (SNAP), formerly referred to as Food Stamps?
Yes
No
Is at least one parent/guardian an active duty member of the United States military?
Yes
No
Is at least one parent/guardian a veteran of the United States military?
Yes
No
Child (Applicant)
Use this section to tell us about your child whom you would like to enroll in our program. If you are an expectant mother wishing to apply for Early Head Start please complete this section with your information.
First Name (Required)
Last Name (Required)
Suffix
Nickname
Birthday (Required)
Gender
Female
Male
Race
American Indian or Alaska Native
Asian
Black or African American
Multi-racial/Biracial
Native Hawaiian/Other Pacific Islander
Unspecified
White
Hispanic
Yes
No
English Proficiency
Little
Moderate
None
Proficient
Other Language
American Sign Language
Amharic
Arabic
Chinese
English
Filipino
French
German
Indonesian
Japanese
Khmer
Mandarin
Marshallese
Mixteco
Punjabi
Romanian
Russian
Spanish
Swinomish
Tagalog
Thai
Triqui
Ukranian
Vietnamese
Other Language Proficiency
Little
Moderate
None
Proficient
Primary Health Coverage
Children's Health Insurance Program (CHIP)
Combined Medicaid/CHIP
Medicaid
No Insurance
Other
Private Health Insurance
Doctor/Medical Home
Anacortes Family Medicine
Bellingham Bay Family Med
Bellingham Birthing Center
Berliner, Dr. Carl
Carolyn Conner
Cascade Ear Nose & Throat
Cascade Family Physicians
Cascadia Eye
Childrens Therapy at SVH
Community Health Center Everett
Compass Health
DSHS
Eberhardt Vision Center
Eventide Health
Fairhaven Integrative Health
Fairhaven Pediatrics
Fidalgo Medical Associates
Friday Harbor Family Clinic
Greenbank Birth Center
Healthy Island Youth Initiative
Hope Central Pediatrics
Island County Health Department
Island Family Physicians
Island Health
Island Hearing Healthcare
Island Optometry
Joy Curtis
Kaiser Everett Medical Center
MEDICAL PROVIDER LIST
Naval Health Clinic Oak Harbor
North Cascade Eye Institute
North Cascade Family Physicians
North Whidbey Community Clinic
Northwest Eye Surgeons
Orcas Family Health Center
Out of Area
Parent Education (internal)
Peace Health - Burlington/Sedro
Peace Health Bellingham
Peace Health Medical Center
Peace Health Medical Records ALL
Pediatric Associates Of Whidbey
Physicians Care Family Medicine
Planned Parenthood
Pregnancy Choices
Providence Medical all offices
RESOURCE LIST/DIRECTORY
Robblee, Nancy
Robertson, Suzanne
Safe Harbor Free Clinic
San Juan County Public Health
San Juan Lions Club
Schoonover, Donna
Sea Mar Concrete
Seamar Marysville
SeaMar Mount Vernon Medical
Seattle Childrens Hospital
Seattle Childrens Opthamology
Seattle Indian Health Board
Sedro Woolley Family Medicine
Sedro-Woolley Vision Center
Sensibly Sprouted
Shilling, David
Simply Sprouted
Skagit Crisis Center
Skagit Cty. Public Health
Skagit Family Health Clinic
Skagit Natural Family Medicine
Skagit Pediatrics
Skagit Recovery Center
Skagit Reg. Clinic (River Bend)
Skagit Reg. Clinics (Mt.V)
Skagit Reg. Clinics (Sedro)
Skagit Regional Clinic (Arligton
Skagit Valley Hospital
Small Miracles
Smith, Andrea
South Whidbey Pediatrics
Speciality Health Care
Steps (previously TLC)
Sunrise Dental Group
SVC Nursing Program
Swedish Medical - Edmonds
Swinomish Tribal Health Center
The Everett Clinic
United General Hospital Dis. 304
Unity Care Northwest
Upper Skagit Tribal Clinic
Valley Kids Therapy
Valley Roots Family Care
Valley Vision & Optical
Vision Plus
Welcome Baby
Whatcom Family Medicine
Whidbey Community Physicians
Whidbey General South
Whidbey Health Medical Center
Whidbey Vision Care
White, Chris
WIC Office (local)
Wish 'n' U Clinic
Women's Clinic Center
Dental Coverage
Children's Health Insurance Program (CHIP)
Combined Medicaid/CHIP
Medicaid
No Insurance
Other
Private Health Insurance
Dentist/Dental Home
ABCD - Island County
All Smiles Dentistry
Apple Ped Dentistry ALL CLINICS
Bellingham Pediatric Dentistry
Berner, Dr. Gary E.
Burlington Family Dentistry
CE Family Dental
Cedar Grove Dental
Cedarcrest Dental Center
Dr. Turnage DDS
Fernandez Dental
Friday Harbor Dentistry
Gage Family Dental
Galbraith Mtn. Pediatric Dentist
Gentle Dental Mount Vernon
Hilde Family Dentistry
Interfaith Clinic - Unity Care
Island Dental
Keyes, Dr. Gordon
Kiraly, Dr.
Kiraly, Susan
Kulshan Pediatric Dentistry
Larson Pediatric Dentistry
Little Pearls Kids Dentistry
Marysville Kids Dentistry
Medical Teams Int. dental mobile
Michael Lemme, DDS: Family Denti
Mountain View Dental Center
North Cascade Cares
North Whidbey Community Dental
Northwest Dental
Oak Harbor Pediatric Dentistry
Odessa Brown Clinic
Out of Area
Perry Family Dentistry
Piper Ped Dentistry
Playhouse Dental Clinic
Puget Sound Ped Dentistry
RESOURCE LIST/DIRECTORY
Roosevelt Dental Center
Sea Mar Oak Harbor Dental
SeaMar Bellingham
Seamar Everett
SeaMar Mount Vernon Dental
Seattle Children's Dental Clinic
Sedro Woolley Family Dental Cent
Skagit Valley Family Dental
Smile Design MV
Smile Mobile
Smiles Dental SW
Speciality Health Care
Stellar Kids Everett
Sunrise Dental Group
Sunshine Ped Dentistry
Swanson Ped Dental
Swinomish Dental Office
The Dental Place Dr. Waletzko
The Tooth Ferry
Two Rivers Dental
Unity Care Northwest
Upper Skagit Tribal Clinic
Vasquez Dentistry
Whidbey Dental Assoc.
Willamette Dental
Wyman Dental
Does your child have a disability or do you have any concerns about your child's development?
Yes
No
Is there anything else you want to tell us about your child?
Location Preferences
Which program are you applying for? (Required)
Early Head Start
Family support and early learning program for pregnant women and children ages birth to three
Preschool Head Start
No cost preschool for children ages 3 to 5 who qualify
1st Location Preference
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2nd 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 your application. The next step in the process is to determine if your family qualifies for the program. There are many ways children are eligible for Head Start. You can expect a follow up email within 5-10 business days with more information about the documentation needed to determine eligibility. If you do not receive it, please check your spam/junk folder! For immediate questions please contact Andrea, our enrollment manager at andrea.garner@skagit.edu.
Required information is missing, see above.