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STOP - BEFORE YOU APPLY: Early Head Start serves children until age three ONLY. Monday - Friday, 9:00 am - 3:00 pm; transportation not provided. EHS has an active waitlist. To be eligible, your child must be either: A Foster Child; Experiencing housing insecurity; In a family that receives TANF, SNAP, or SSI; or In a family below the Federal Poverty Level. For support, please email: ehsinfo@humankind.org.

First Name (Required)

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

Opt In for Text Messages

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.

Race

Hispanic

Lives with Family

English Proficiency

Other Language

Highest Grade Completed

Employment Status

Child's Relationship (Required)

Custody (Required)

Teen Parent

If you are living with others to avoid homelessness, this may qualify your child for EHS. Email ehsinfo@humankind.org for support.

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)

Last Name (Required)

Birthday (Required)

Gender

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

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.

Race

Hispanic

Lives with Family

English Proficiency

Other Language

Highest Grade Completed

Employment Status

Child's Relationship

Custody

Teen Parent

Are there other adults in the household?

Add Another Adult

Number of Parents/Guardians

Relationship to Participant(s)

Primary Language at Home

Is another language being acquired or learned at home?

Number in Household

Number in Family

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? (Required)

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

Add Emergency Contact

Your child is not eligible for Early Head Start if over age three!

First Name (Required)

Last Name (Required)

Birthday (Required)

Gender

Race

Hispanic

Primary Health Coverage (Required)

Medicaid Eligibility (Required)

Medicaid Number (Required)

Doctor/Medical Home (Required)

Dentist/Dental Home (Required)

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

YOUR APPLICATION IS NOT COMPLETE. Please click "Save and Continue", and a confirmation email will be sent. You must provide Documentation of Eligibility within 30 days, or your application will be denied. There are no current openings but Early Head Start will work closely with you once an opening occurs or provide resources for other childcare services. Email ehsinfo@humankind.org for questions or support.

Required information is missing, see above.

Parent/Guardian

Address

Additional Parent/Guardian

Other Adults

Family Information

Emergency Contacts

Child (Applicant)

Location Preferences

Additional Applicant

Siblings