Thank you for your interest in our programs! Please complete the following information and someone from one of our sites will contact you to set up an appointment time. The information requested in this application can be completed here or if you prefer you can complete only the name (first, last), birthday (of guardian), email address and phone number. We will contact you within a week to set up an appointment time to review this information.
Parent/Guardian
Please fill out all required fields so we can contact you. If you have any questions about the application, please call 207-739-6536 and speak with our Head Start Coordinator.
First Name (Required)
Last Name (Required)
Birthday (Required)
Gender
Female
Male
Non-Binary
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.
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
Bengali
Cantonese
Chinese
Dutch
English
Filipino
Flemish
French
Fuzhouniese
German
Greek
Hebrew
Italian
Japanese
Korean
Lao/Laotian
Mandarin
Portuguese
Russian
Spanish
Swahili
Tagolog
Turkish
Vietnamese
Highest Grade Completed
Associate's Degree
Bachelor's Degree
College Degree/Training Cert.
College or Advance Training
Doctorate
General Education Diploma
High School Graduate
Less than a High School Graduate
Master's Degree
Employment Status
Full-time & Training
Full-time (35 hours/week or more)
Part-time & Training
Part-time (Under 35 hours/week)
Retired or Disabled
Seasonally Employed
Training or School
Unemployed
Child's Relationship
Biological/Adopted/Step
Foster
Grandchild
Other
Other Relative
Address
Please fill out all required fields so we can contact you. If you have any questions about the application, please call 207-739-6536 and speak with our Head Start Coordinator.
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.
Mailing Address same as Living Address
Mailing Address
Address Line 2
City
State
ZIP
Child (Applicant)
Please fill out all required fields so we can contact you. If you have any questions about the application, please call 207-739-6536 and speak with our Head Start Coordinator.
First Name (Required)
Last Name (Required)
Birthday (Required)
Gender
Female
Male
Non-Binary
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
Bengali
Cantonese
Chinese
Dutch
English
Filipino
Flemish
French
Fuzhouniese
German
Greek
Hebrew
Italian
Japanese
Korean
Lao/Laotian
Mandarin
Portuguese
Russian
Spanish
Swahili
Tagolog
Turkish
Vietnamese
Other Language Proficiency
Little
Moderate
None
Proficient
Is there anything else you want to tell us about your child?
Location Preferences
Which program are you applying for? (Required)
Head Start 2023-2024
Preschool for children ages 3 to 5 or full time childcare
Early Head Start 2023-2024
Childcare or Home Visiting for children ages birth to 3 as well as pregnant mothers
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
Thank you for your interest in our Head Start program. Please press Submit to finalize your application. We will contact you within a week to set up an appointment time to review this information. Any questions, please call (207) 739-6538.
Required information is missing, see above.