Please fill in all the fields listed below to enroll in Early Head Start or Head Start in Marshall County or Starke County in Indiana.
Parent/Guardian
Please enter your phone number on this page, so we can contact you to complete the application.
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)
Click here
to find a provider in your area.
Additional Parent/Guardian
Only complete this section if the Secondary Adult is currently living in the home and related by blood, marriage, or adoption.
Is there another parent/guardian in the family?
Yes
No
First Name (Required)
Last Name (Required)
Birthday (Required)
Family Information
"Participant" is defined as the child you wish to enroll. "Family" is defined as all persons living in the same household who are supported by the income of the parent(s) or guardian(s) of the child enrolling. If you have no income, please indicate "0" in the gross annual income box.
Number in Family (Required)
Gross Annual Income
Is your family receiving cash benefits or other services under the Temporary Assistance for Needy Families (TANF) program?
Yes
No
Is your family receiving Supplemental Security Income (SSI)?
Yes
No
Is your family receiving services under the Supplemental Nutrition Assistance Program (SNAP), formerly referred to as Food Stamps?
Yes
No
Child (Applicant)
First Name (Required)
Last Name (Required)
Birthday (Required)
Location Preferences
Which program are you applying for? (Required)
Early Head Start 25-26
Head Start 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 our Head Start / Early Head Start program. Please click submit to finalize your application. We will contact you to set up an intake appointment. If you have any questions call Rae at 574-936-7885.
Required information is missing, see above.