Thank you for your interest in Juniata County Head Start, Early Head Start and Pre-K Counts. We offer families living in Juniata County three great FREE preschool options for children up to 5 years of age and expectant mothers. In order for a family to qualify for services you must either be income or categorically eligible and provide proof of income at enrollment. Please complete each section of this application in it's entirety in order to ensure that we receive accurate information regarding your child and family.
Parent/Guardian
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
Home Phone
Work Phone
Ext.
SSN
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)
Middle Name
Last Name (Required)
Birthday (Required)
Gender
Female
Male
Mobile Phone
Home Phone
Work Phone
Ext.
SSN
Family Information
Number of Parents/Guardians
One Parent Family
Two Parent Family
Primary Language at Home
English
Italian
Spanish
Twi
Number in Family
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
Child (Applicant)
First Name (Required)
Middle Name
Last Name (Required)
Suffix
Nickname
Birthday (Required)
Gender
Female
Male
SSN
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)
EHS 2018-2019
Head Start 2018-2019
Pre-K Counts 2018-2019
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
Again, thank you for your interest in our program. Please click submit to finalize your application. We will contact you soon to discuss your options; however, if you have any further questions please contact Sue Dunn at 717-436-2405.
Required information is missing, see above.