Please be sure to fill out ALL fields for qualifying purposes.
Please answer questions about education and income based on the date of the application. For teen parents, only enter "Yes" if 19 years or younger on the date of the application.
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Only complete this section if the Secondary Adult is currently living in the home, being supported by the same income and related blood marriage or adoption.
For TANF, SSI, WIC or SNAP only answer "Yes" if you are currently receiving benefits. Proof of Income and copies of awards letters will be requested.
If your child has an IEP or IFSP in place, please place the diagnosis along with services begin and end dates in the notes section below.
- Your Address - Available Locations
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Do you want to apply now for another child in your family?

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Are there other children in the family?

Add a Sibling
Thank you so much for your interest in our Head Start program. Someone will be in touch with you after reviewing your application.
Required information is missing, see above.