Dear Parent (s) \ Guardian (s). Thank you for visiting our application page. (Please note all information shared with us is strictly confidential). Please complete the entire application to begin the registration process. If you have any questions about how to fill out this application, please email ECEDapplication@cmcs.org.
Parent/Guardian
First Name (Required)
Last Name (Required)
Birthday (Required)
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.
Address
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
Family Information
Primary Language at Home
African
African Languages (Swahili, Mandinke, etc.)
African Languages(French)
African Languages(French)
American Sign Language
Caribbean
Caribbean Languages (Creole, Patois, etc.)
Dialect: Mixteco
Dialect: Nahuatl-Mexico
Dialect: Tlapaneco-Mexico
East Asian
East Asian Languages (Chinese, Vietnamese, etc.)
English
European & Slavic
European and Slavic Languages (German, French, Russian, Yiddish, etc.)
French
Italian
Mandingo-Mandika/Wolof Gambia
Middle Eastern & South Asian
Middle Eastern and South Asian (Arabic, Hebrew, Hindi, Urdu etc.)
Native Central American, South American & Mexican
Native Central American, South American and Mexican Languages (Mixteco, Quichean, etc.)
Native North American/ Alaska Native Languages
Other
Pacific Island
Pacific Island Languages (Palauan, Fijian, etc.)
Quechua(mainly speaks in Peru, Ecuador, Colombia, Bolivia and argentina
Sapoteco-Mexico
Sonike-Gambia, Senegal
Spanish
Spanish
Swahili
Unspecified
Unspecified (Unknown or Declined)
Yoruba-Nigeria
Is another language being acquired or learned at home?
Yes
No
Child (Applicant)
First Name (Required)
Last Name (Required)
Birthday (Required)
Location Preferences
Which program are you applying for? (Required)
Head Start
Children Ages 3-5 years old
Early Head Start
Pregnant Women, and Children Ages 0 to 3
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 completing the application , a staff member will be in touch with you soon. Please visit our web site (https://cmcs.org), and our Facebook page (https://www.facebook.com/cardinalmccloskey) for more information about our programs.
Required information is missing, see above.