This is the first step to applying for Drake University Head Start/Early Head Start program. Once initial information is received, program staff will contact you to schedule an in person application appointment. Please include all children you wish to complete an application for on this one New Family Pre-Application. If your family has previously applied for or had a child enrolled in Drake University Head Start, you will need to contact the Central Office by calling 515-271-1854 or emailing Stacie Dahlin at stacie.dahlin@drake.edu
Parent/Guardian
First Name (Required)
Last Name (Required)
Birthday (Required)
Gender
Female
Male
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
Yes
No
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.
English Proficiency
Little
Moderate
None
Proficient
Other Language
Afanoso
Albanian
Aleut
American Sign Language
Amharic
Arabic
Arakanese
Armenia
Assyrian
Bangla
Bosnian
Burmese
Cambodian
Chatino
Chin-Dialect not specified
Chinese
Chin-Falam
Chin-Hakha
Chin-Mizo
Chuukese
Creole
Croatian
Dinka
English
Ewe
Farsi
Fijian
Filipino
French
Gio
Gujarati
Haitian
Hindi
Hmong
Indonesian
Italian
Japanese
Kachin
Kannada
Kannkanaey
Karen
Karenni
Kayan
Khmer
Kibembe
Kikuyu
Kimbe
Kinyamulenge
Kinyarwanda
Kirundi
Kissi
Kono
Korean
Korku
Kotokoli
Kpelle
Krahn
Krio
Kru
Kunama
Kurdish
Laotian
Lithuania
Luganda
Mabaan
Malay
Mandarin
Mandingo
Mano
Marathi
Marenge
Mirconesia
Mon
Mung
Nepali
Neur
Nigerian
Nuba
Ogoni
Omoro
Pashto
Persian
Polish
Portuguese
Punjabi
Rakhine
Rohingya
Russian
Saho
Samoan
Sango
Senthang
Shan
Sign Language
Sinhala
Somali
Spanish
Sudanese
Swahili
Tagalog
Tamil
Teluga
Thai
Tigrinya
Tompa
Turkish
Twi
Ukraine
Urdu
Vietnamese
Zapotec
Zomi
Zotung
Employment Status
Full-time & Training
Full-time (35 hours/week or more)
Part-time & Training
Part-time (Under 35 hours/week)
Retired or Disabled
Seasonally Employed
Training or School
Unemployed
Address
Is your family experiencing homelessness?
Yes
No
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
Additional Parent/Guardian
Is there another parent/guardian in the family?
Yes
No
First Name (Required)
Last Name (Required)
Birthday (Required)
Gender
Female
Male
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
Yes
No
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.
English Proficiency
Little
Moderate
None
Proficient
Other Language
Afanoso
Albanian
Aleut
American Sign Language
Amharic
Arabic
Arakanese
Armenia
Assyrian
Bangla
Bosnian
Burmese
Cambodian
Chatino
Chin-Dialect not specified
Chinese
Chin-Falam
Chin-Hakha
Chin-Mizo
Chuukese
Creole
Croatian
Dinka
English
Ewe
Farsi
Fijian
Filipino
French
Gio
Gujarati
Haitian
Hindi
Hmong
Indonesian
Italian
Japanese
Kachin
Kannada
Kannkanaey
Karen
Karenni
Kayan
Khmer
Kibembe
Kikuyu
Kimbe
Kinyamulenge
Kinyarwanda
Kirundi
Kissi
Kono
Korean
Korku
Kotokoli
Kpelle
Krahn
Krio
Kru
Kunama
Kurdish
Laotian
Lithuania
Luganda
Mabaan
Malay
Mandarin
Mandingo
Mano
Marathi
Marenge
Mirconesia
Mon
Mung
Nepali
Neur
Nigerian
Nuba
Ogoni
Omoro
Pashto
Persian
Polish
Portuguese
Punjabi
Rakhine
Rohingya
Russian
Saho
Samoan
Sango
Senthang
Shan
Sign Language
Sinhala
Somali
Spanish
Sudanese
Swahili
Tagalog
Tamil
Teluga
Thai
Tigrinya
Tompa
Turkish
Twi
Ukraine
Urdu
Vietnamese
Zapotec
Zomi
Zotung
Employment Status
Full-time & Training
Full-time (35 hours/week or more)
Part-time & Training
Part-time (Under 35 hours/week)
Retired or Disabled
Seasonally Employed
Training or School
Unemployed
Child (Applicant)
First Name (Required)
Last Name (Required)
Suffix
Birthday (Required)
Gender
Female
Male
English Proficiency
Little
Moderate
None
Proficient
Other Language
Afanoso
Albanian
Aleut
American Sign Language
Amharic
Arabic
Arakanese
Armenia
Assyrian
Bangla
Bosnian
Burmese
Cambodian
Chatino
Chin-Dialect not specified
Chinese
Chin-Falam
Chin-Hakha
Chin-Mizo
Chuukese
Creole
Croatian
Dinka
English
Ewe
Farsi
Fijian
Filipino
French
Gio
Gujarati
Haitian
Hindi
Hmong
Indonesian
Italian
Japanese
Kachin
Kannada
Kannkanaey
Karen
Karenni
Kayan
Khmer
Kibembe
Kikuyu
Kimbe
Kinyamulenge
Kinyarwanda
Kirundi
Kissi
Kono
Korean
Korku
Kotokoli
Kpelle
Krahn
Krio
Kru
Kunama
Kurdish
Laotian
Lithuania
Luganda
Mabaan
Malay
Mandarin
Mandingo
Mano
Marathi
Marenge
Mirconesia
Mon
Mung
Nepali
Neur
Nigerian
Nuba
Ogoni
Omoro
Pashto
Persian
Polish
Portuguese
Punjabi
Rakhine
Rohingya
Russian
Saho
Samoan
Sango
Senthang
Shan
Sign Language
Sinhala
Somali
Spanish
Sudanese
Swahili
Tagalog
Tamil
Teluga
Thai
Tigrinya
Tompa
Turkish
Twi
Ukraine
Urdu
Vietnamese
Zapotec
Zomi
Zotung
Does your child have a disability or do you have any concerns about your child's development?
Yes
No
Location Preferences
Which program are you applying for? (Required)
Early Head Start 2023-24
Free Early Education Services for Children under the age of 3
Head Start 2023-24
Free Preschool for Children Ages 3-5
1st Location Preference
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2nd Location Preference
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- Your Address
- Available Locations
Click a location on the map to see more info
Click here
to find a provider in your area.
Additional Applicant
Do you want to apply now for another child in your family?
Add Another Applicant
Siblings
Are there other children in the family?
Add a Sibling
Thank you for submitting your initial information. Program staff will contact you to schedule an in person application appointment. Any changes to the initial information can be updated at the time of the application appointment.
Required information is missing, see above.