Thank you for taking the time to fill out our Early Head Start application! We are looking forward to getting to know more about your child and family, our Early Head Start Program is designed for prenatal mothers, and children 6 weeks to 3 Years. This application has multiple parts, please make sure you fill out the initial application, attach any necessary documents that would help us better serve your family and child and fill out our final questionnaire at the end. If you have any questions or need assistance please call Sonely Rivera at 518-292-5510 and choose option 6.
Please Complete each section
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Are there other adults in the household?

Add Another Adult
*If you are a prenatal mother applying for our home based program option- please fill out this section accordingly-in the First Name field please fill in as "unborn", in the Last Name field please fill in as the last name you plan on giving your child and for the birth date please fill in as the expected due date of your child.
- Your Address - Available Locations
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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
Required information is missing, see above.