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 806-677-5360. 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. 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)
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.
Race
American Indian or Alaska Native
Asian
Black or African American
Multi-racial/Biracial
Native Hawaiian/Other Pacific Islander
Other
Unspecified
White
Hispanic
Yes
No
English Proficiency
Little
Moderate
None
Proficient
Other Language
African Languages
American Sign Language
Caribbean Languages
East Asian Languages
English
European and Slavic Languages
Middle Eastern and South Asian Languages
Native Central American, South American, and Mexican Languages
Native North American/Alaska Native
Pacific Island Languages
Spanish
Other Language Proficiency
Little
Moderate
None
Proficient
Highest Grade Completed
Associate's Degree
Bachelor's Degree
College Degree/Training Cert.
College or Advance Training
General Education Diploma
Grade 10
Grade 11
Grade 12
Grade 9 or less
High School Graduate
Master's Degree
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's Relationship
Biological/Adopted/Step
Foster
Grandchild
Other
Other Relative
Custody
Yes
No
Teen Parent
Yes
No
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.
Mailing Address same as Living Address
Mailing Address
Address Line 2
City
State
ZIP
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)
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.
Race
American Indian or Alaska Native
Asian
Black or African American
Multi-racial/Biracial
Native Hawaiian/Other Pacific Islander
Other
Unspecified
White
Hispanic
Yes
No
English Proficiency
Little
Moderate
None
Proficient
Other Language
African Languages
American Sign Language
Caribbean Languages
East Asian Languages
English
European and Slavic Languages
Middle Eastern and South Asian Languages
Native Central American, South American, and Mexican Languages
Native North American/Alaska Native
Pacific Island Languages
Spanish
Highest Grade Completed
Associate's Degree
Bachelor's Degree
College Degree/Training Cert.
College or Advance Training
General Education Diploma
Grade 10
Grade 11
Grade 12
Grade 9 or less
High School Graduate
Master's Degree
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's Relationship
Biological/Adopted/Step
Foster
Grandchild
Other
Other Relative
Custody
Yes
No
Family Information
Please enter the information below.
Number of Parents/Guardians
One Parent Family
Two Parent Family
Relationship to Participant(s)
Foster parent(s) not including relatives
Grandparent(s)
Other
Parent(s) (e.g. biological, adoptive, stepparents)
Relative(s) other than grandparents
Primary Language at Home
African Languages
American Sign Language
Caribbean Languages
East Asian Languages
English
European and Slavic Languages
Middle Eastern and South Asian Languages
Native Central American, South American, and Mexican Languages
Native North American/Alaska Native
Pacific Island Languages
Spanish
Is another language being acquired or learned at home?
Yes
No
Number in Family
Gross Annual Income
Is your family receiving cash benefits or other services under the Temporary Assistance for Needy Families (TANF) program?
Yes
No
Is your family receiving Supplemental Security Income (SSI)?
Yes
No
Is your family receiving services from WIC?
Yes
No
Is your family receiving services under the Supplemental Nutrition Assistance Program (SNAP), formerly referred to as Food Stamps?
Yes
No
Is at least one parent/guardian an active duty member of the United States military?
Yes
No
Is at least one parent/guardian a veteran of the United States military?
Yes
No
Child (Applicant)
Please enter your child's information below.
First Name (Required)
Middle Name
Last Name (Required)
Suffix
Birthday (Required)
Gender
Female
Male
Race
American Indian or Alaska Native
Asian
Black or African American
Multi-racial/Biracial
Native Hawaiian/Other Pacific Islander
Other
Unspecified
White
Hispanic
Yes
No
English Proficiency
Little
Moderate
None
Proficient
Other Language
African Languages
American Sign Language
Caribbean Languages
East Asian Languages
English
European and Slavic Languages
Middle Eastern and South Asian Languages
Native Central American, South American, and Mexican Languages
Native North American/Alaska Native
Pacific Island Languages
Spanish
Other Language Proficiency
Little
Moderate
None
Proficient
Primary Health Coverage
Children's Health Insurance Program (CHIP)
Combined Medicaid/CHIP
Medicaid
No Insurance
Other
Private Health Insurance
State-Only Funded Insurance
Other Coverage
Children's Health Insurance Program (CHIP)
Combined Medicaid/CHIP
Medicaid
No Insurance
Other
Private Health Insurance
State-Only Funded Insurance
Insurance Number
Medicaid Eligibility
Not Eligible
On Medicaid
Potentially Eligible
Medicaid Number
Doctor/Medical Home
Adams. Gretchen, MD
Advance Eye Care
After Hours Clinic NM
Amarillo Children's Clinic
Amarillo Family Physicians
Amarillo First Urgent Care
Amarillo OBGYN Associates
Amarillo Pediatric Clinic
Amarillo Speech and Hearing
Amarillo STAT Care
Amarillo Urgent Care
Area Eye Center in Perryton
Bal4 Eyes, inc
Balford Optical
Balfour Optical - Borger
Barnes, Layne, MD
Betty, Claude, MD
Black, Keith, MD
Borger Medical Clinic
Bowers Pharmacy
Bridges, Walter, MD
Brigance, Harold, MD
Broome Optical
Brown, Krista FNP-C
Brown, Paul, MD
Bryant, Shari, FNP
BSA Family Medical Clinic
BSA Family Medicine
BSA Hospital
BSA Urgent Care
Bullock, Linda, CPNP
Bunch, Chris MD
Caldwell, MD
Care Options for Kids
Care Today Clinic
Carexpress
Carter, Bonnie MD
Castro County Healthcare
Center For Family Medicine
Chad Kennedy
Chandler, Pamela MD
Chastain, David, MD - OBGYN
Chastain, MD
Childers, Manon, MD
Children's Health Care Assoc
Childress Regional Hospital
City Of Amarillo Health Depart.
Clarendon Family Medical
Clark, Robert, MD
Clinic For Family Wellness
Coalition Of Health Services
Cogdell Rural Health Clinic
Collingsworth Family Medicine
Community Health Center
Cook Children's Genetics
Cook Childrens
Cook MD
Cook's Children's
Covenant Medical Center
Cox, Eric, MD
Crane Memorial Hospital
Crispina Chen M.D.
Crnic, Tracy, MD
CVS Pharmacy
Dalhart FMC
Darter, TC, Dr
Deloach, Derrell MD
Derrick, Trudy, MD
DeWitt, Blake MD
Dhir, Gunjan, DDS
Dimmitt Medical Clinic
Dr Igar
Dr. Fiallo
Dr. Hammon
Dr. Husainy
Dr. J Malone
Dr. Jerry Malone
Dr. Johnni Farrvloth
Dr. Juan Viola
Dr. Manuel Juson
Dr. Obrock
Dr. Quo
Dr. Rachel Anderson
Dr. Romeo Sanglang
Dr. Sean Groff
Dr. Sean Wengroff
Dr. Todd Bell
Dr. Watkins
Dr. Wilhelm
Dumas Family
Dumas Vision Source
Dutton, Perlita M. MD
East, William, MD
ECI Early Childhood Intervention
Ellen Hampton
Epic Pediatric Therepy Services
Faith Medical - Canyon
Faith Medical - Hereford
Family Care Clinic
Family Care Clinic
Family Healthcare
Family Medical Clinic
Family Physicians
Family Support Services
Faris, Bud MD
Farwell Medical Clinic
Fletcher, Rex, MD
Flood, Carmen, NP
Floyd, Deirdre, RN
Fox Rural Health Clinic
Freedom Clinic
Freeman-Ladd, Mayra, MD
Friona Rural Health Clinic
Fritch Clinic
Galey, Jennifer, FNP
Genesis House
George, Cindy, MD
George, Miranda, MD
Ghishan MD
Goetz, Susan, MD
Gorden, Shawn, MD
Goverdhana, Shyam MD
Graham, Gordan, MD
Graham, MD
Graves, Scott, MD
Guttenplan, Michael, MD
Habersang, Rolf, MD
Hale, William, MD
Hall County Rural Health Clinic
Hamid, Abdool, MD
Hansen, Holly, MD
Hansford County Hospital
Hart School Based Health Clinic
Harvester Health and Wellness
Haven Health Clinic
Hawley, Dustin, MD
Head Start Specialist
Heal The City Free Medical Clini
Health Solutions Med Center
Henderson, James, Dr
Hereford Health Clinic
Hereford Regional Medical Center
Herring, Randy, MD
Higgins, Sheila, FNP
High Country Community Health
High Plains EENT
Hillside Family Clinic
Hines, Randy, MD
Holly, MD
Horton MD
Hoving, Debbie, MD
Howard, John, MD
Huang, MD
Indigent Medical Ctr Of Dimmitt
Irvin, Marc, MD
Irwin, Marc, MD
Johnson, Howard, MD
Johnson, Julia, ED
Jones, Peter, FNP
Julian, MD
Jurado, Samuel, PA
Justin Amaro, DO
Kennedy, Kyle, MD
Kim, Caleb, FNP
Kim, Sang, DO
Klemon, Kathy PNP
Kuo, MD
La Casa Family Health Center
LabCorp
Lacken, Diane, MD
Ladd, MD
Lakko
LEA/ISD Local Education Agency
Levelland Clinic North
LHC Family Medicine
Lowry, Larry, DO
Lucero, Mariana E, MD
Luckstead, Eugene, MD
Maaytah, Taghreed, MD
Mann, Rex, MD
Mann, Wallace, MD
Martin Road Eye Care
McCullough, Brenda, FNP
McGaughy, Jennifer, MD
McKenzie, MD
Medford, Sheri, MD
Medical Center of Dimmitt
Medical Clinic Of Muleshoe
Meeks, Lacy, FNP
Meeks, MD
Mendoza, Ruben, MD
Merchant, John, MD
Meyers, Jane, FNP
Moore County Clinic
Moore County Family Health Clini
Morgan, Stacie, MD
Muleshoe Area Medical Center
Muleshoe Family Medical Clinic
Muleshoe Outpatient Clinic
Murcia, Jaime, MD
Nailing, Amy OD
Nash, Michael, MD
Nguyen, Giang, MD
Nguyen, Lan, DDS
Nguyen, MD
Northwest Texas Physicians Group
Northwest Texas Urgent Care
NWTH
NWTH Women's & Children's Clinic
Oasis Medical
Ojo Family Eye Care
Ontai, Sidney, MD
Option Care
Ormson, Kerry, MD
OUT OF STATE
Outreach Health Services
Pampa Medical Clinic
Panhandle OBGYN
Panhandle Pediatrics
Parmer County Community Hosp.
Paul Firth
Payne, Gerald, MD
Pedi Providers
Pediatric Wellness Center
Perryton Health Center
Plains Regional Medical Center
Plainview Children's Rural Healt
Plainview Rural Health Clinic
Plunk, Dennis, MD
Pope, MD
Powers, Cathy, FNP
Pratt, Dustin, Dr
Presbyterian Medical Hospital
Progressive Steps
Purdy, Bruce, MD
Purdy, Tyson, MD
Purl, Carmen MD
Qian, Baoping, MD
Rabe, Laurie, RN, FNP
Ray, Janice, FNP
Regence Clinic/Tyler Street Res
Regence Health Network
Regence Health Network
Regence Health Network -Hereford
Regence South Health Network Inc
RGH Clinic
Rhoton, Joel, MD
Ridens, Dondi, MD
Roberts, Joyce MD
Saadeh, Constatine, MD
Salado, Genie, PA
Sanson-jaraczewski, Jayne, MD
Schneider, Martin, MD
Schubert, Bruce, MD
Scott, Rebecca, MD
Shamrock General Hospital
Sheehan, Marita, MD
Sheets, MD
Siewert, Rick, MD
Soriano, Karen MD
South Plains Health Providers
South Plains Health Providers
South Plains Pediatrics
Spearman Family Medical Clinic
St. Lukes Eye Institute
Stratford FMC
Sudan Medical Clinic
Sunray Clinic
Texas Department of State Health
Texas Tech - Lubbock
Texas Tech Family Medicine
Texas Tech OBGYN
Texas Tech Pediatrics
Therepy 2000
Thetford, MD
Tulia Rural Health Clinic
Turner, Matthew, MD
Upton, Amy, FNP
Vermadahl, Nathan, MD
Vickers, David, MD
Wal Mart Pharmacy
Walsh, Meganne, MD
Ward, Carol, FNP
Ward, Carol, MD
Weber, Ammon, MD
Well Life Family Medicine
Werner, Carmen, MD
West Texas Family Medicine
West Texas Pediatrics
Wheeler Rural Health
WIC
WIC - North Branch
WIC - Southeast Clinic
Williams, MD
Williams, Sheri, MD
Women & Children - NWTH
Women And Children - SE
Womens Healthcare Associates
Wright, David, MD
Wright, Geoffrey, MD
Wright, Ruth, MD
WTAMU
X-Press Care
Yaws, Jennifer, FNP
Young, John, MD
Dental Coverage
Children's Health Insurance Program (CHIP)
Combined Medicaid/CHIP
Medicaid
No Insurance
Other
Private Health Insurance
State-Only Funded Insurance
Dental Coverage Number
Dentist/Dental Home
Abbeville Denistry - Amarillo
Abbeville Denistry - Lubbock
Allen II, Zoel, DDS
Allington Dental
Alver, Brian DDS
Amarillo College Dental Hygiene
Amarillo Dental associates
Amarillo Dental Solutions
Amarillo Dental Spa
Amarillo Dental Works
Amarillo Family Dentistry
Amarillo Oral & Maxillofacial Su
Amarillo Pediatric Dentistry
AOMS Pediatric Dentistry
ASAP Dental
Banks, J Steven DDS
Barry, Larry, DDS
Baucum J R, DDS
Black and Ruiz, DDS
Bonner. David, DDS
Borger Smiles
Brown, Gary, DO
Browning, Randall, DDS
Bryson, Neil, DDS
Burgin, Jeremy, DDS
Canyon Family Dental
Casa Dental
Chambers, Kyle, DDS
Chan, Peter, DDS
Children's Denistry Of Amarillo
Children's Dentistry of Wichita
Childress Dental Office
Class 1 Dental
Covenant Community Outreach Dent
David Woodburn
Davis, Michael Derek, MD
De Vries, Eric, DDS
Dental Group of Amarillo
Dentistry for Kids
DeVries, DDS
Double T Smiles
Dr. Byrd Adkins
Dr. Chilton, DDS
Dr. Para
Dr. Pendergrass
Dumas Family Denistry
Dunham, Richard DDS
EP Dentistry
Familia Dental
Familia Dental - New Mexico
Familia Dental - Clovis NM
Familia Dental - Lubbock
Fritch Dental Group
Fry, Stan, DDS
Garcia, Annelle, DDS
Gifford, DDS
Goldston, Shadid
Green, Eric DDS
Hart School Based Health Clinic
Hastings, William, DO
Hennessey, Charlie, DDS
Hunt, John, DDS
Ivins, JR, DDS
Janssen, Dustin DDS
Johnson, Dale, DDS
Johnson, Jay, DDS
Johnson, John, DDS
Kelly, Gregory, MD
Kemp, Jim, DDS
Kennel, Dietmar, DDS
Keys, Kevin, DDS
Kidskare Dental
King, Kevin, DDS
Kolar Matthew, DDS
Kool Smiles
Kool Smiles
La Casa Family Dentistry
Lamb Dental
Lepard, Robert, DDS
Lindsey, Lorra Cantu DDS
Lubbock Kids Dental
Malone DDS
Merritt, Ken, DDS
Metcalf, Billy, DDS
Moore County Clinic
Moore, DDS
Moore, Shane, DDS
Naggs, Jeffry DDS
Nguyen, Angela, DDS
Nguyen, Lan, DDS
Oneida Dental
Ormson Family Dentistry
Out of area
OUT OF STATE
Pampa Dental Associates
Pampa Pediatric Denistry
Panhandle Dental
Parkview Pediatric Dentistry
Parmer, Jay, DDS
Pieratt, JM, DDS
Pinkerton, James, MD
Plunk, Dennis DDS
Pope, Kevin, DDS
Powell Family Denistry
Presbyterian Dental Clinic
Presbyterian Parkway Dental Clin
Purdy, David, DDS
Regence Health Network
Regence Health Network -Hereford
Roden, Rick, DDS
Rolling Plains Family Dentistry
Ruiz Family Dental
Shemen Dental Group
Sheppard, Richard, DDS
Simple Kids Dental
Smile Accent
Smile Workshop
Smile Zone
Smith, Barbara, DDS
Smith, Duane, DDS
Smith, Mike, DDS
Star Kids
Tinkler
Vaclav, Michael, DDS
Valencia, Erica, DDS
Vernon Smiles
West Texas Family Medicine
West, Daniel, DDS
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
Program for children ages 3 and 4 depending on site.
Early Head Start
Program from birth up to 3 years old
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
Thank you for your interest in the Region 16 ESC Head Start/Early Head Start Program. Please click "submit application" to finalize your application. 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.