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STOP - BEFORE YOU APPLY: Operating hours are Monday - Friday, 9:00 am - 3:00 pm; transportation is not provided. EHS only serves children up to 36 months (3 years) and has an active waitlist. EHS is a federal program, subject to eligibility criteria. To be found eligible, you must provide documentation that your child meets at least one of the following circumstances: 1) Foster Child, Relative placement, custody, or adoption; 2) Child is unhoused or experiencing verifiable housing insecurity; 3) Child is in a family that receives TANF, SNAP, or SSI; 4) Child is in a family with income at or below the Federal Poverty Level for their household size. If you previously applied for Early Head Start for any child, you may be unable to complete this process without assistance. Please email EHS for support: 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

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

First Name (Required)

Last Name (Required)

Birthday (Required)

Gender

Race

Hispanic

Primary Health Coverage (Required)

Medicaid Eligibility (Required)

Medicaid Number

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 when your application is received. 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 to ensure your child is either placed on the waitlist or you are provided 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