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Thank you for your interest in SCS Head Start. If your child will turn 3 on or before September 30, 2023 please proceed with the application for the 2023-2024 school year. Please be aware that household income verification as well as your child's immunization records and most recent physical must be submitted before the application can be processed.

Income Verification will need to be submitted for the application to be considered for enrollment. Acceptable income documentation is; proof of Child Support, Income Tax Form (W-2, 1040), Pay Stubs, Supplemental Security Income, Public Assistance (TANF, SNAP), Unemployment, Written Statement from Employers, SSI/SSDI Statement, Foster Care/Adoption Payment, Bank Statements. If you receive SNAP benefits, and can provide documentation you do not need to provide Income documentation. A picture of your SNAP benefits card is acceptable documentation Medical records are also needed and need to include Immunization records and your child's most recent physical Exam.

First Name (Required)

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.

SSN

Race

Hispanic

Highest Grade Completed (Required)

Employment Status (Required)

Child's Relationship (Required)

Custody (Required)

Lives with Family (Required)

Provides Financial Support (Required)

Teen Parent

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)

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.

SSN

Race

Hispanic

Highest Grade Completed

Employment Status

Child's Relationship (Required)

Custody (Required)

Lives with Family (Required)

Provides Financial Support (Required)

Are there other adults in the household?

Add Another Adult

Number of Parents/Guardians (Required)

Relationship to Participant(s) (Required)

Primary Language at Home (Required)

Is another language being acquired or learned at home? (Required)

Number in Household (Required)

Number in Family (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?

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

Add Emergency Contact

Household income verification and a copy of your child's immunization records and most recent physical exam will need to be submitted before the application can be processed.

First Name (Required)

Last Name (Required)

Birthday (Required)

Gender (Required)

SSN

Race (Required)

Hispanic (Required)

English Proficiency (Required)

Other Language (Required)

Primary Health Coverage (Required)

Other Coverage

Doctor/Medical Home (Required)

Dental Coverage (Required)

Dentist/Dental Home (Required)

Does your child have a disability or do you have any concerns about your child's development? (Required)

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

Thank you for your interest. Once the required documents are submitted, the application will be processed and communication from the Southwestern Community Services Head Start Administration Office will follow. Please make sure you have provided a phone number as well as an email address for timely follow up from the Head Start Program.

Required information is missing, see above.

Parent/Guardian

Address

Additional Parent/Guardian

Other Adults

Family Information

Emergency Contacts

Child (Applicant)

Location Preferences

Additional Applicant

Siblings