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Thank you for considering BrightSpark's Early Head Start & Bright Beginnings Maternal Support Program to support you in giving your child with the best possible start in life!

Our program is designed to nurture strong relationships between your child and the adults in their lives in inclusive, anti-racist, child-centered environments. We welcome pregnant individuals and children up to age four to apply!

Through our partnerships with licensed Family Child Cares, enrolled families not only benefit from high-quality, full-day, year-round childcare, but also receive essential support with basic needs, such as diapers, gas & food cards, and car seats. Additionally, we offer a comprehensive range of services tailored to help your family thrive through pregnancy and beyond!

To determine eligibility, please complete the application form below. A dedicated team member will review your application promptly and respond within two days.

Parent/Guardian

Please complete this section using the primary caregiver's or expectant parent's information.

First Name (Required)

Last Name (Required)

Birthday (Required)

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

Employment Status

Child's Relationship

Lives with Family

Teen Parent

Address

Please enter your child’s primary residence or where they spend most of their time. If applying as a pregnant person, please enter your address.

If you do not have a fixed, regular, or adequate nighttime residence, including if you are sharing housing or "doubled up" due to the loss of housing, economic hardship, or similar reason, please indicate "yes" to the first question.

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.

Additional Parent/Guardian

Use this section if there is an additional care-giver/partner you would like to be connected to this application.

Is there another parent/guardian in the family?

First Name (Required)

Last Name (Required)

Birthday (Required)

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

Employment Status

Child's Relationship

Lives with Family

Provides Financial Support

Family Information

Information provided in this section will help us speed up the application process and determine eligibility.

Number of Parents/Guardians

Number in Household

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?

Child (Applicant)

If you are an expectant individual applying for our Bright Beginnings program, please complete this section to the best of your knowledge, using expected due date for Birthday and entering "TBD" for any sections not yet known.

First Name (Required)

Last Name (Required)

Birthday (Required)

Gender

Race

Hispanic

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?

Location Preferences

Which program are you applying for? (Required)

BrightSpark's Early Head Start & Bright Beginnings

Comprehensive care for infants & toddlers, compassionate support for families!

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.

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 taking the time to complete this application! We appreciate your interest in enrolling in BrightSpark's Early Head Start & Bright Beginnings program. We look forward to supporting you soon!

After you click the “Save and Continue” button below, you will be invited to upload attachments. Doing so will help speed up the application and enrollment process but is not necessary at this time. To complete your application click "Done" on the next page. You will receive an email confirming that your application has been received. Please feel free reach out to us at any time, either through email at ehs@childcare or phone at 206-471-8104 as well!

Required information is missing, see above.