Thank you for your interest with the Head Start/ Early Head Start program. If you have already completed an online application for any of your children in the past, please call 407-532-4365 for the status of your application. Before beginning the application below, we recommend that you gather the following required documents: Verification of age: Child's birth certificate or Passport. Verification of income: Previous 12 months income, W2 (previous year),1040 (previous year), Most recent income, Paystub, Child Support, TANF, SSI/SSA, SNAP, Financial Aid, Verification of residency: Lease, Mortgage statement, Utility Bill of lease/mortgage holder *Other verification option for families experiencing homelessness. Thank you.
Parent/Guardian
You must complete all areas for this application to be submitted. Not filling in ANY area or question, will not allow you to submit an online application. If answers to questions are not applicable, please type "n/a" so that the application is allowed to be submitted.
First Name (Required)
Middle Name
Last Name (Required)
Suffix
Birthday (Required)
Gender
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
Opt In for Text Messages
Yes
No
Home Phone
Work Phone
Ext.
It appears that you have previously submitted an application. If you wish to apply again, please contact us by phone or in person.
English Proficiency
Little
Moderate
None
Proficient
Other Language
American Sign Language
Arabic
Chinese
Creole
English
French
Hindu
Japanese
Other
Persian
Portugese
Spanish
Vietnamese
Other Language Proficiency
Little
Moderate
None
Proficient
Address
Please make sure that all fields are answered with current information.
Is your family experiencing homelessness?
Yes
No
Living Address (Required)
Address Line 2
City (Required)
State (Required)
ZIP (Required)
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to find a provider in your area.
Mailing Address same as Living Address
Mailing Address
Address Line 2
City
State
ZIP
Additional Parent/Guardian
For this program, the "Second adult" is considered the spouse or biological parent of the child, that is also living in the household, you are applying for. You must complete all areas for this application to be submitted. Not filling in ANY area or question, will not allow you to submit an online application. If answers to questions are not applicable, please type "n/a" so that the application is allowed to be submitted.
Is there another parent/guardian in the family?
Yes
No
First Name (Required)
Middle Name
Last Name (Required)
Suffix
Birthday (Required)
Gender
Female
Male
English Proficiency
Little
Moderate
None
Proficient
Other Language
American Sign Language
Arabic
Chinese
Creole
English
French
Hindu
Japanese
Other
Persian
Portugese
Spanish
Vietnamese
Other Language Proficiency
Little
Moderate
None
Proficient
Child (Applicant)
Applicants are the child who you are applying for services for. If you are applying for multiple children, you will need to complete an application for each child. Applicants who are applying for the Pregnant Mother's program, please write "Unborn" for the child's first name.
First Name (Required)
Last Name (Required)
Birthday (Required)
Location Preferences
Which program are you applying for? (Required)
4C Early Head Start-EXP-NPE - 2023-2024
4C Early Head Start 2023-2024
4C Head Start 2023-2024
4C Early Head Start -CCP 2023-2024
1st Location Preference
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2nd 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
Siblings
Are there other children in the family?
Add a Sibling
Thank you for your interest in the Head Start and Early Head Start Program. Please click submit to finalize your application. We will contact you to set up an intake appointment.
Required information is missing, see above.