**For NEW families only. Returning families please call the center for an appointment.** Thank you for your interest in the Delaware County Intermediate Unit’s Head Start program! Please enter all information accurately and to the best of your knowledge on the subsequent pages. To register for Head Start for the current school year, your child MUST have turned 3 years old on or before September 30th. To register your child for the next school year, your child MUST be 3 years old on or before September 30th. If you are registering two children, and one is birth - 36 months, you will need to complete a separate Early Head Start application. You will need all of the following to complete your online application: Name and birth date of every person in the house, your address and phone number, an email address for primary adult, and if applicable, secondary adult, health Insurance card for insurance numbers, and name and phone number for doctor and dentist. You MUST complete the application at one time. If there is a particular site you would like your child to attend, you will have the option to specify which site you prefer. Once you have completed and submitted your application, a confirmation email will be sent to the email address you provided. If you do not have an email address, you will need to create one prior to continuing.

Parent/Guardian

Please enter all of the information below for the primary adult. Primary adult refers to the parent or legal guardian completing the application. You must be the parent or legal guardian of the child to create the application.

Address

Click here to find a provider in your area.

Additional Parent/Guardian

Please enter all of the information below for the secondary adult. Secondary adult refers to the second parent or legal guardian of the child living in the same house, if applicable. If the child’s second parent/guardian lives in a different house, please leave this screen blank.

Family Information

Please enter all of the information below accurately. Here are some helpful hints when completing this information. Parental Status = a Single Parent family – if only one of the child’s parents live in the house, a Two Parent family – if both of the child’s parents live in the same house, and a Grandparent family – if grandparent(s) have guardianship/custody of child.

Emergency Contacts

Child (Applicant)

Please enter all required information. The child you are registering for Head Start is considered the Applicant. The medical coverage information will be located on the child’s health insurance card.

Location Preferences
- 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
Please check your email for a confirmation of your application submission. Your application will be forwarded to the appropriate staff and you will hear from us shortly to set an appointment to bring required documents. To further prepare for your appointment, please gather the following documents. These documents will be required to complete your registration. Without the following, your registration will be considered incomplete. The required documents are: - Birth certificates for all children in the house. - Proof of income. (If paid bi-weekly, you need to bring two (2) consecutive paystubs. If paid weekly, you need to bring four (4) consecutive paystubs. You can also bring your W-2, 1040 or 1090 from the previous year. If you receive public assistance, child support, SSI or are applying for a foster child, please bring the print-out indicating the amount you receive monthly). - Physical – must be current within one year. - Up-to-date immunization records (shot records). - Dental – must be current within six months. - Health Insurance card. - Allergy forms (If your child has any allergies, please make sure to bring completed allergy forms to your appointment). - Picture ID for all adults in the house. - Recent utility bill. - WIC ID (If you are receiving WIC services). Again, we look forward to working with your family! Thank you for partnering with us!
Required information is missing, see above.