Apply Online

Head Start 10 Program Application: 2026–2027

Dear Parents and Guardians:

Please complete the first step of the online application process for the Economic Improvement Council Head Start 10 Program for the 2026–2027 program year.

After you submit the initial application, a staff member will contact you to help complete the process and submit any additional required documents.

Documents That May Be Required

Proof of income for all household members covering the last 12 months or the previous calendar year, such as:
- Federal income tax return or W-2 form
- Current pay stubs or military Leave and Earnings Statement (LES)
- Work First Family Assistance (WFFA) or TANF letter
- A computerized child-support payment record covering the last 12 months for all children in the household
- SSI, SSDI, Social Security, retirement, veterans, or alimony benefit statements
- Unemployment, disability, or other income documentation
Your child’s immunization record, which must be completed before your child begins the program
A certified copy of your child’s birth certificate or other acceptable proof of age if a certified birth certificate is unavailable

Questions or Assistance

If you have questions about the application or required documents, please contact:

Tracy Stokely
tracy.stokely@eicca.org

A member of our application office will be happy to assist you.

First Name (Required)

Middle Name

Last Name (Required)

Birthday (Required)

Gender

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

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.

Is your family experiencing homelessness?

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

Is there another parent/guardian in the family?

First Name (Required)

Middle Name

Last Name (Required)

Birthday (Required)

Gender

Mobile Phone

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.

Are there other adults in the household?

Add Another Adult

Number of Parents/Guardians

Relationship to Participant(s)

Primary Language at Home

Number in Household

Number in Family

Gross Annual Income

Is your family receiving cash benefits or other services under the Temporary Assistance for Needy Families (TANF) program?

Is your family receiving Supplemental Security Income (SSI)?

Is your family receiving services from WIC?

Is your family receiving services under the Supplemental Nutrition Assistance Program (SNAP), formerly referred to as Food Stamps?

Is at least one parent/guardian an active duty member of the United States military?

Is at least one parent/guardian a veteran of the United States military?

First Name (Required)

Middle Name

Last Name (Required)

Suffix

Nickname

Birthday (Required)

Gender

Race and/or Ethnicity - To specify multiracial and/or multiethnic please check all races and/or ethnicities that apply

American Indian or Alaska Native

Asian

Black or African American

Hispanic or Latino

Middle Eastern or North African

Native Hawaiian or Pacific Islander

White

Primary Health Coverage

Other Coverage

Medicaid Number

Doctor/Medical Home

Dental Coverage

Dentist/Dental Home

Does your child have a disability or do you have any concerns about your child's development?

Is there anything else you want to tell us about your child?

Which program are you applying for? (Required)

Location Preference

1st Location Preference

2nd Location Preference

3rd Location Preference

- Your Address - Available Locations

Click a location on the map to see more info

Click here to find a provider in your area.

Do you want to apply now for another child in your family?

Add Another Applicant

Are there other children in the family?

Add a Sibling

I certify that the information given on this application is true and accurate and all income has been reported and is subject to verification by the program. I understand that this information is being given for services provided by federal and/or state funds and that deliberate misrepresentation of any information will disqualify me from services.

Required information is missing, see above.

Head Start 10 Program Application: 2026–2027

Documents That May Be Required

Questions or Assistance

Parent/Guardian

Address

Additional Parent/Guardian

Other Adults

Family Information

Child (Applicant)

Location Preferences

Additional Applicant

Siblings