Welcome to the CDCFC Head Start! After completing the Family Pre-application, you will be contacted to complete the application.
Parent/Guardian
Enter information about the child's primary guardian.
First Name (Required)
Last Name (Required)
Birthday (Required)
Gender (Required)
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 (Required)
Opt In for Text Messages
Yes
No
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.
Race
American Indian or Alaska Native
Asian
Black or African American
Multi-racial/Biracial
Native Hawaiian/Other Pacific Islander
Other
Unspecified
White
Hispanic
Yes
No
English Proficiency
Little
Moderate
None
Proficient
Other Language
Albanian
American Sign Language
Amharic
Arabic
Awngi
Bangwa
Bassa
Bayangi
Bengali
Berber
Burmese
Catalan
Chinese
Creole
Croatian
Dagbani
Dari
Dutch
English
Fijian
French
Fulani
German
Gujarati
Haitian-Creole
Hindi
Hmong
Igbo
Ijaw
Indonesian
Isoko
Italian
Japanese
Kazakh
Kikuyu
Kinyarwanda
Korean
Kunama
Kurdish
Kwale
Lao
Limba
Lorma
Maimai
Malay
Mandingo
Medumba
Mixteco
Mmuock
Nepali
Oromo
Palauan
Pashayi
Pashto
Patois
Persian
Pidgin
Polish
Portuguese
Punjabi
Quichean
Russian
Sarakule
Serbian
Shupamum
Sinhalese
Somali
Soninke
Spanish
Swahili
Telugu
Thai
Tigrinya
Turkish
Twi
Urdu
Uzbek
Vai
Vietnamese
Wolof
Yiddish
Yoruba
Zomi
Other Language Proficiency
Little
Moderate
None
Proficient
Child's Relationship
Biological/Adopted/Step
Foster
Grandchild
Other
Other Relative
Address
Enter your permanent or temporary living address.
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.
Family Information
Enter information for the household.
Primary Language at Home
Albanian
American Sign Language
Amharic
Arabic
Awngi
Bangwa
Bassa
Bayangi
Bengali
Berber
Burmese
Catalan
Chinese
Creole
Croatian
Dagbani
Dari
Dutch
English
Fijian
French
Fulani
German
Gujarati
Haitian-Creole
Hindi
Hmong
Igbo
Ijaw
Indonesian
Isoko
Italian
Japanese
Kazakh
Kikuyu
Kinyarwanda
Korean
Kunama
Kurdish
Kwale
Lao
Limba
Lorma
Maimai
Malay
Mandingo
Medumba
Mixteco
Mmuock
Nepali
Oromo
Palauan
Pashayi
Pashto
Patois
Persian
Pidgin
Polish
Portuguese
Punjabi
Quichean
Russian
Sarakule
Serbian
Shupamum
Sinhalese
Somali
Soninke
Spanish
Swahili
Telugu
Thai
Tigrinya
Turkish
Twi
Urdu
Uzbek
Vai
Vietnamese
Wolof
Yiddish
Yoruba
Zomi
Is another language being acquired or learned at home?
Yes
No
Child (Applicant)
Enter information pertaining to the child you are enrolling.
First Name (Required)
Last Name (Required)
Birthday (Required)
Gender
Female
Male
Race
American Indian or Alaska Native
Asian
Black or African American
Multi-racial/Biracial
Native Hawaiian/Other Pacific Islander
Other
Unspecified
White
Hispanic
Yes
No
English Proficiency
Little
Moderate
None
Proficient
Other Language
Albanian
American Sign Language
Amharic
Arabic
Awngi
Bangwa
Bassa
Bayangi
Bengali
Berber
Burmese
Catalan
Chinese
Creole
Croatian
Dagbani
Dari
Dutch
English
Fijian
French
Fulani
German
Gujarati
Haitian-Creole
Hindi
Hmong
Igbo
Ijaw
Indonesian
Isoko
Italian
Japanese
Kazakh
Kikuyu
Kinyarwanda
Korean
Kunama
Kurdish
Kwale
Lao
Limba
Lorma
Maimai
Malay
Mandingo
Medumba
Mixteco
Mmuock
Nepali
Oromo
Palauan
Pashayi
Pashto
Patois
Persian
Pidgin
Polish
Portuguese
Punjabi
Quichean
Russian
Sarakule
Serbian
Shupamum
Sinhalese
Somali
Soninke
Spanish
Swahili
Telugu
Thai
Tigrinya
Turkish
Twi
Urdu
Uzbek
Vai
Vietnamese
Wolof
Yiddish
Yoruba
Zomi
Other Language Proficiency
Little
Moderate
None
Proficient
Location Preferences
Which program are you applying for? (Required)
Early Head Start 2024-2025
Ages 6 weeks to 3 years
Head Start 2024-2025
Ages 3 to 5 years
Location Preference
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1st Location Preference
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2nd Location Preference
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3rd 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 interest in CDCFC! We look forward to serving your family in the future! A Family Service Worker or Home Visitor will be contacting you to schedule the face to face application.
Required information is missing, see above.