Please complete entire application. After you have submitted it, a staff person will contact you to set up a time to meet with you to go over the application and collect your income documentation. If anyone in your family has previously applied for our Head Start Pre-Birth to Five program please stop and email Income documentation is required to process your application. • We will need 12 months' worth of your household income. o Examples: Federal Tax Form from the previous year, W-2's from all jobs held the previous year, SNAP, TANF, Supplemental Security Income (SSI) Statement, child support or Paystubs showing the last 12 months. Please also have your child's immunizations and state birth certificate available.
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ONLY list if living in household
In application notes please list any allergies or medical concerns your child may have.
- Your Address - Available Locations
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Add Another Applicant

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Add a Sibling
You will receive an email confirmation once the application is submitted. We will contact you soon.
Required information is missing, see above.