Welcome! Important, Please read! If you have a CHILD ENROLLED in Head Start or Early Head Start, Please DO NOT COMPLETE AN ONLINE APPLICATION. Contact your local Head Start/Early Head Start Office at 806-677-5421 or 806-677-5333. If you have to leave a message, include your child's name, date of birth and a telephone number or e-mail address and a staff member will get back to you as soon as possible. To finalize the application, you will be required to provide the following: Proof of Age, Current Immunization Record, Proof of Income or Public Assistance (SNAP, SSI, TANF) or Foster Form 2085. NEW APPLICANT ONLY This is the first step in the process of completing the Head Start/Early Head Start (HS/EHS) application. Please complete the brief online application below and be sure to enter a contact phone number and email address.
Parent/Guardian
Please enter your information below. Please be sure to enter a contact phone number.
First Name (Required)
Middle Name
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
African Languages/Arabic
African Languages/Bantu
African Languages/Chichewa
African Languages/Kirundi
African Languages/other
African Languages/Setswana
African Languages/Somali
African Languages/Swahili
African Languages/Tigrinya
African Languags/Somalia
American Sign Language
Asian Languages/Arabic
Asian Languages/Burmese
Asian Languages/Chinese
Asian Languages/Farsi
Asian Languages/Hindi
Asian Languages/Japanese
Asian Languages/Korean
Asian Languages/Lao
Asian Languages/Mandarin
Asian Languages/other
Asian Languages/Punjabi
Asian Languages/Thai
Asian Languages/Vietnamese
Caribbean Languages
English
European and Slavic Languages
Native Central American, South American, and Mexican Languages
Native North American/Alaska Native
Pacific Island Languages
Spanish
Spanish
Child's Relationship
Biological/Adopted/Step
Foster
Grandchild
Other
Other Relative
Address
Please enter your contact information below.
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.
Additional Parent/Guardian
Only complete if there is a second adult living in the home.
Is there another parent/guardian in the family?
Yes
No
First Name (Required)
Middle Name
Last Name (Required)
Birthday (Required)
Gender
Female
Male
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
African Languages/Arabic
African Languages/Bantu
African Languages/Chichewa
African Languages/Kirundi
African Languages/other
African Languages/Setswana
African Languages/Somali
African Languages/Swahili
African Languages/Tigrinya
African Languags/Somalia
American Sign Language
Asian Languages/Arabic
Asian Languages/Burmese
Asian Languages/Chinese
Asian Languages/Farsi
Asian Languages/Hindi
Asian Languages/Japanese
Asian Languages/Korean
Asian Languages/Lao
Asian Languages/Mandarin
Asian Languages/other
Asian Languages/Punjabi
Asian Languages/Thai
Asian Languages/Vietnamese
Caribbean Languages
English
European and Slavic Languages
Native Central American, South American, and Mexican Languages
Native North American/Alaska Native
Pacific Island Languages
Spanish
Spanish
Child's Relationship
Biological/Adopted/Step
Foster
Grandchild
Other
Other Relative
Family Information
Please enter the information below.
Number of Parents/Guardians
One Parent Family
Two Parent Family
Number in Household
Child (Applicant)
Please enter your child's information below.
First Name (Required)
Middle Name
Last Name (Required)
Suffix
Birthday (Required)
Gender
Female
Male
Does your child have a disability or do you have any concerns about your child's development?
Yes
No
Is there anything else you want to tell us about your child?
Location Preferences
Which program are you applying for? (Required)
Head Start
Services for children ages 3-4
Early Head Start
Prenatal and from birth until three years old
Location Preference
<p></p>
1st Location Preference
<p></p>
2nd Location Preference
<p></p>
3rd Location Preference
<p></p>
- 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
Thank you for your interest in the Region 16 ESC Head Start/Early Head Start Program. A Head Start/Early Head Start staff person will contact you to schedule an in-person or telephone interview to complete the application process.
Required information is missing, see above.