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ACHR's Head Start (HS) program serves children who are ages 3 to 5 years old. Children must be 3 on or before September 1. All Head Start slots that are in our centers are from 8:00 am to 2:30 pm. ACHR’s Early Head Start (EHS) serves infants and toddlers, birth to 3 years old. We have an EHS program that is home based which serves pregnant moms and children birth to 3 years old as well. Our EHS center based option, is open from 8:00 am to 3:00 pm. We can provide wrap-around care on a sliding fee scale for a limited number of Head Start and Early Head Start children at both Darden and Edelman.

Please answer questions about education, employment and income based on the date of the application. For teen parents, only enter 'Yes' if 19 years or younger on the date of application.

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

English Proficiency

Other Language

Other Language Proficiency

Highest Grade Completed

Employment Status

Child's Relationship

Custody

Lives with Family

Provides Financial Support

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

Only complete this section if the Secondary Adult is currently living in the home, being supported by the same income and related blood marriage or adoption.

Is there another parent/guardian in the family?

First Name (Required)

Middle Name

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

English Proficiency

Other Language

Other Language Proficiency

Highest Grade Completed

Employment Status

Child's Relationship

Custody

Lives with Family

Provides Financial Support

Teen Parent

Are there other adults in the household?

Add Another Adult

For TANF, SSI, WIC or SNAP only answer 'Yes' if you are currently receiving those benefits. Proof of Income and copies of awards letters will be requested.

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?

Add Emergency Contact

PREGNANT MOM NOTE - If you are applying for the Early Head Start program as a prenatal, please fill out the child application. Where the application asks "is there anything you want to tell us about your child?" please write your baby's due date. WE WELCOME CHILDREN WHO HAVE SPECIAL NEEDS! If your child has an IEP or IFSP or referral, please check yes under "disability" AND indicate IEP or IFSP in the following box "Is there anything else you want to tell us about your child?"

First Name (Required)

Middle Name

Last Name (Required)

Suffix

Nickname

Birthday (Required)

Gender

Race

Hispanic

English Proficiency

Other Language

Other Language Proficiency

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 submitting your initial application. You will be contacted by a Family Services Advocate or Parent Educator if further documentation is required, and upon approval of your application. Priority for final enrollment is based on an established point system.

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