Apply Online

Building Strong Foundations with Alaska Native Families through Alaska Native Cultures and Education.

Welcome to Cook Inlet Native Head Start's online application. CINHS is a Tribal Head Start and Alaska Native and American Indian children are priorized.
NOTE: To help speed up the process please fill in all fields on application [Don't Leave Blanks]
Once you have submitted your application we will need the following documents:
*Birth Certificate
*Documented Proof of Indian Blood
*Proof of Residency (utility bill; phone bill)
*Proof of Legal/Foster/Relative Guardianship (if not the child’s biological parent)
*Last 12 Months Income (Tax Return(s) [does not apply to Foster/ Kinship guardians] , or: print outs of W-2, Pay stubs, SNAP/ATAP/TANF, SSI, Unemployment Benefits, Child Support, etc.)
Documents can be faxed, dropped off, or using your smart phone, take pictures and send them through email.
Fax number: 907-433-1651, If you have questions filling this out call Mary or Ariel @ 433-1600 / 433-1601
Drop off location: 6901 E. Tudor Road, or 370 W 16th ave
Email them to: mshanigan@cinhs.net and ajohnson@cinhs.net.

PROGRAM INFORMATION
Full Day Program 6 weeks - 3 years olds (Monday through Friday/Thursday *see calendar)
Full Day Program 3 years olds- 5 year olds (Monday through Thursday) - 7:30 AM to 3:00 PM or 9:00 AM- 4:30 PM
Part Day Program 3-5 year olds (Monday through Thursday) - 3.5 hours per day.
Times available are:
~7:30 AM to 11:00 AM
~9:00 AM to 12:30 PM
~12:00 PM to 3:30 PM, or
~1:30 PM to 5:00 PM

Home Based Services
This program services Prenatal to 3 years old. Home Based Teachers are home visitors who would come to your home on a weekly basis for 1 hour and 30 minutes. (*due to COVID services are different)

Please indicate which program you are interested in, when ERSEA Specialist, Mary S. or Ariel Johnson, calls to confirm your application.
*INCLUDE everyone living in the home!

Please complete ALL sections.

First Name (Required)

Middle Name

Last Name (Required)

Suffix

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 (Required)

Other Language

Other Language Proficiency

Highest Grade Completed

Employment Status

Child's Relationship

Custody

Lives with Family

Provides Financial Support

Teen Parent

If Teen Parent, Subsidized?

Please complete ALL sections.

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

Please complete this section for every person (including children) in your household. Thank you.

Is there another parent/guardian in the family?

First Name (Required)

Middle Name

Last Name (Required)

Suffix

Birthday (Required)

Gender

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

If Teen Parent, Subsidized?

Are there other adults in the household?

Add Another Adult

Please complete ALL sections.

Number of Parents/Guardians

Relationship to Participant(s)

Primary Language 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?

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?

Child's information you are applying for. Please complete ALL sections.

First Name (Required)

Middle Name

Last Name (Required)

Suffix

Nickname

Birthday (Required)

Gender (Required)

Race (Required)

Hispanic (Required)

English Proficiency (Required)

Other Language

Other Language Proficiency

Primary Health Coverage

Other Coverage

Insurance Number

Medicaid Eligibility

Medicaid Number

Doctor/Medical Home

Dental Coverage

Dental Coverage Number

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

Head Start is 3-5years and EHS is Prenatal-3years
**Please put any allergies, health or dietary needs about the child in the section:(is there anything else you want to tell us about your child)
An email will be sent to you once you have submitted your application.
Our ERSEA Specialist, Mary S. or Ariel Johnson, will contact you once she processes your application with the needed documents on file, or if she needs additional information.
If she has not contacted you within a week, you can call the office, 433-1600 or 433-1601, to get an update on your application.
Thank you for considering us to be a part of your child's education.

Required information is missing, see above.

Parent/Guardian

Address

Additional Parent/Guardian

Other Adults

Family Information

Child (Applicant)

Location Preferences

Additional Applicant

Siblings