Thank you for your interest in Head Start, Early Head Start, or Early Head Start ChildCare Partnership. Please complete the application below, ensuring to fill in as many boxes as possible.
Parent/Guardian
First Name (Required)
Last Name (Required)
Suffix
Birthday (Required)
Gender (Required)
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 (Required)
Opt In for Text Messages
Yes
No
Home Phone (Required)
Work Phone (Required)
Ext.
It appears that you have previously submitted an application. If you wish to apply again, please contact us by phone or in person.
Child's Relationship (Required)
Biological/Adopted/Step
Foster
Grandchild
Other
Other Relative
Veteran (Required)
Yes
No
Address
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
Additional Parent/Guardian
Is there another parent/guardian in the family?
Yes
No
First Name (Required)
Last Name (Required)
Suffix
Birthday (Required)
Email Address
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.
Family Information
Primary Language at Home (Required)
American Sign Language
English
French
Other
Portuguese
Spanish
Is another language being acquired or learned at home?
Yes
No
Is your family receiving cash benefits or other services under the Temporary Assistance for Needy Families (TANF) program? (Required)
Yes
No
Is your family receiving Supplemental Security Income (SSI)? (Required)
Yes
No
Is your family receiving services from WIC? (Required)
Yes
No
Is your family receiving services under the Supplemental Nutrition Assistance Program (SNAP), formerly referred to as Food Stamps? (Required)
Yes
No
Child (Applicant)
First Name (Required)
Last Name (Required)
Suffix
Birthday (Required)
Gender (Required)
Female
Male
Does your child have a disability or do you have any concerns about your child's development? (Required)
Yes
No
Is there anything else you want to tell us about your child?
Location Preferences
Which program are you applying for? (Required)
Early Head Start 0-3 years old
Head Start 3-5 years old
HSP 25-26
EHS 25-26
Location Preference
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1st Location Preference
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2nd Location Preference
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3rd 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 Program. Please click submit to finalize your application. We will contact you soon to finish the application process.
Required information is missing, see above.