Thank you for your interest in Great Start Early Childhood Programs and Services. Please complete all of the following information for your children ages 0-5 living in Cass County. If you have previously submitted an application with us or receive an error with entering your application, please call our ISD enrollment specialist Vicki Foote at 269-445-6283 or contact her at vicki.foote@hsisd.org with any questions.
Parent/Guardian
Complete the following information for the parent or legal guardian.
First Name (Required)
Middle Name
Last Name (Required)
Suffix
Birthday (Required)
Gender
Female
Male
Other
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
Albanian
American Sign Language
Amharic
Arabic
Armenian
Azeri
Bengali
Bosnian/Croation
Bulgarian
Burmese
Chinese (Cantonese)
Chinese (Fujianese)
Chinese (Mandarin)
Czech
English
Estonian
Farsi
French
Georgian
German
Gujarati
Hausa
Hebrew
Hindi
Hungarian
Ibo
Indonesian
Kazakh
Khmer (Cambodian)
Kinyarwanda
Korean
Kurdish
Latvian
Lingala
Lithuanian
Macedonian
Malay
Marathi
Mongolian
Nepali
Other
Palauan
Panjabi
Polish
Portuguese
Pushto
Romanian
Russian
Serbian
Shona
Sinhalese
Slovak
Somali
Spanish
Swahili
Tagalog
Tamil
Telagu
Thai
Tigrignia
Turkish
Twi
Ukranian
Urdu
Uzbeck
Vietnamese
Yoruba
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 the child's address of residence here.
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
If there are two parents or legal guardians, please fill out the following information for the second adult.
Is there another parent/guardian in the family?
Yes
No
First Name (Required)
Middle Name
Last Name (Required)
Suffix
Birthday (Required)
Gender
Female
Male
Other
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
Albanian
American Sign Language
Amharic
Arabic
Armenian
Azeri
Bengali
Bosnian/Croation
Bulgarian
Burmese
Chinese (Cantonese)
Chinese (Fujianese)
Chinese (Mandarin)
Czech
English
Estonian
Farsi
French
Georgian
German
Gujarati
Hausa
Hebrew
Hindi
Hungarian
Ibo
Indonesian
Kazakh
Khmer (Cambodian)
Kinyarwanda
Korean
Kurdish
Latvian
Lingala
Lithuanian
Macedonian
Malay
Marathi
Mongolian
Nepali
Other
Palauan
Panjabi
Polish
Portuguese
Pushto
Romanian
Russian
Serbian
Shona
Sinhalese
Slovak
Somali
Spanish
Swahili
Tagalog
Tamil
Telagu
Thai
Tigrignia
Turkish
Twi
Ukranian
Urdu
Uzbeck
Vietnamese
Yoruba
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
Lives with Family
Yes
No
Family Information
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
Albanian
American Sign Language
Amharic
Arabic
Armenian
Azeri
Bengali
Bosnian/Croation
Bulgarian
Burmese
Chinese (Cantonese)
Chinese (Fujianese)
Chinese (Mandarin)
Czech
English
Estonian
Farsi
French
Georgian
German
Gujarati
Hausa
Hebrew
Hindi
Hungarian
Ibo
Indonesian
Kazakh
Khmer (Cambodian)
Kinyarwanda
Korean
Kurdish
Latvian
Lingala
Lithuanian
Macedonian
Malay
Marathi
Mongolian
Nepali
Other
Palauan
Panjabi
Polish
Portuguese
Pushto
Romanian
Russian
Serbian
Shona
Sinhalese
Slovak
Somali
Spanish
Swahili
Tagalog
Tamil
Telagu
Thai
Tigrignia
Turkish
Twi
Ukranian
Urdu
Uzbeck
Vietnamese
Yoruba
Number in Household
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 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)
First Name (Required)
Middle Name
Last Name (Required)
Suffix
Birthday (Required)
Gender
Female
Male
Other
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
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)
Strong Beginnings 2022-23
Early Childhood Programs and Services
GSRP 2022-23
Early Childhood Programs and Services
Parents as Teachers
Early Childhood Programs and Services
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
Yay! You've completed your first step in applying for Early Childhood Programs and Services! We will contact you this summer to take your next step in the process!
Required information is missing, see above.