Online Application Instructions: Fill out all required fields (those with that say "Required"). Fill out as much as possible the optional fields (the more information we have the better our ability to serve you). Make sure to hit the submit button at the end of the application. By submitting this application online you are certifying that the information given on this application is correct to the best of your knowledge.
Click here to find a provider in your area.
Please fill out the following information on the child you wish to enroll with us. Please note that Medicaid means MaineCare.
- Your Address - Available Locations
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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
The following information is required to process your application. Not supplying the required documentation will delay processing.

• Copy of Child's Official Birth Certificate

• Copy of Child’s most recent immunization record (child must be up-to-date on all immunizations in order to be enrolled in our program per Maine State Law)

• Proof of Income: SNAP, TANF, SSI, or if you do not receive those benefits, please send W-2 or 1040 Tax Form

• If applying for a foster child, please send proof of verification of guardianship

• If unhoused, please reach out to Jesse Westman at / 973-3516 or Kelley Graffam at / 973-3567

You can email those documents to or you can mail them to Penquis Early Head Start/Head Start, PO Box 1162, Bangor, ME 04402-1162. *If neither of these options work, please contact Jesse Westman at 973-3516 and we will figure out another way.

In accordance with Federal Regulations, Penquis does not discriminate in access to or the provision of its services.

By submitting this application online, you are certifying that this information is true. If any part is false, your participation in this agency’s programs may be terminated and may be subject to legal action. You, also understand that the information in this application will be held in strict confidence within the agency and is accessible to you during normal business hours.

Thank you for your interest in Penquis Head Start / Early Head Start. We will be in touch soon to let you know the status of your application.

Required information is missing, see above.