Please complete the following questions to the best of your knowledge. If you have any questions while completing this application, please call Kayla Palmer at (717)337-1337 ext 228 or email at kfpalmer@achsaccess.org. Thank you for your interest in our program! After you complete this application, please send or bring in a copy of your child's birth certificate, proof of income (w-2, income tax 1040 form, two pay stubs, proof that you receive SNAP benefits, signed note from employer, social security, and/or child support documentation) for anyone who is living with and supporting the household. Proof of income & birth certificates can be mailed (705 Old Harrisburg Road, Gettysburg, PA, 17325) or E-mailed kfpalmer@achsaccess.org**************This information is needed to process your child's application.
Please complete all of the following questions about the primary adult (the adult that is completing this application)
Please included your mailing address if it is different than the living address.
Click here to find a provider in your area.
Please complete all of the following questions about the secondary adult. If you have any questions, please call (717)337-1337 ext 228.

Are there other adults in the household?

Add Another Adult
Please complete the following questions
Please complete the following questions about the child that you want in the Adams County Head Start Program.
- 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 in our program! After you complete this application, please send or bring in a copy of your child's birth certificate, proof of income (w-2, income tax 1040 form, two pay stubs, two pay stubs, proof that you receive SNAP benefits, signed note from employer, social security, and/or child support documentation) for anyone who is living with and supporting the household. Proof of income & birth certificates can be mailed (705 Old Harrisburg Road, Gettysburg, PA, 17325) or E-mailed (kfpalmer@achsaccess.org)
Required information is missing, see above.