Apply Online

Dear Families: Thank you for your interest in the YWCA St. Louis Head Start/Early Head Start program. To qualify for services, your child must be age eligible AND your family must either be income or categorically eligible. **Please select ONLY one Program when selecting the Location Preference.** If you are a Pregnant Women that needs services, please select Overland Pregnant Women or the YWCA-Pregnant Women for the West Florissant location. **Family MUST reside in the school district for Ambrose and Maplewood enrollment.**

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

Highest Grade Completed

Employment Status

Child's Relationship

Custody

Lives with Family

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

English Proficiency

Highest Grade Completed

Employment Status

Child's Relationship

Lives with Family

FOR FAMILY'S INCOME - PLEASE BE PREPARED TO PROVIDE EITHER W2S, TAX RETURN, SSI LETTER, CHECK STUBS, AN EMPLOYEE LETTER, CHILD SUPPORT, GRANTS/SCHOLARSHIPS, UNEMPLOYMENT LETTER AND/OR TANF AWARD LETTER.

Number of Parents/Guardians

Relationship to Participant(s)

Primary Language at Home

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?

WIC ID (if applicable)

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?

Add Emergency Contact

First Name (Required)

Middle Name

Last Name (Required)

Suffix

Nickname

Birthday (Required)

Gender

Race

Primary Health Coverage

Medicaid Eligibility

Medicaid Number

Doctor/Medical Home

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

Thank you for your interest in the Head Start Program. Please click submit to finalize your application. We will contact you to setup an intake appointment.

Required information is missing, see above.

Parent/Guardian

Address

Additional Parent/Guardian

Family Information

Emergency Contacts

Child (Applicant)

Location Preferences

Additional Applicant

Siblings