Thank you for your interest in Macon Program for Progress 0-5 Head Start Program. Head Start is a school readiness program focused on preparing children and their families for future success. If at anytime you need help completing the application please contact us at 828-524-4471 ext. 324
Parent/Guardian
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
Hispanic/Latino
Multi-racial/Biracial
Native Hawaiian/Other Pacific Islander
Other
Unspecified
White
Hispanic
Yes
No
Lives with Family
Yes
No
English Proficiency
Little
Moderate
None
Proficient
Other Language
American Sign Language
Chatino
Chinese
English
Gujarati
Russian
Spanish
Spanish
Thai
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
Provides Financial Support
Yes
No
Teen Parent
Yes
No
Enrolled in School
No
Yes
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)
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
Hispanic/Latino
Multi-racial/Biracial
Native Hawaiian/Other Pacific Islander
Other
Unspecified
White
Hispanic
Yes
No
Lives with Family
Yes
No
English Proficiency
Little
Moderate
None
Proficient
Other Language
American Sign Language
Chatino
Chinese
English
Gujarati
Russian
Spanish
Spanish
Thai
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
Provides Financial Support
Yes
No
Teen Parent
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
American Sign Language
Chatino
Chinese
English
Gujarati
Russian
Spanish
Spanish
Thai
Is another language being acquired or learned at home?
Yes
No
Number in Household
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
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
Emergency Contacts
Add Emergency Contact
Child (Applicant)
First Name (Required)
Middle Name
Last Name (Required)
Suffix
Nickname
Birthday (Required)
Gender
Female
Male
Race
American Indian or Alaska Native
Asian
Black or African American
Hispanic/Latino
Multi-racial/Biracial
Native Hawaiian/Other Pacific Islander
Other
Unspecified
White
Hispanic
Yes
No
Lives with Family
Yes
No
English Proficiency
Little
Moderate
None
Proficient
Other Language
American Sign Language
Chatino
Chinese
English
Gujarati
Russian
Spanish
Spanish
Thai
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
Allergy Partners of Western NC
Angel ER
Angel Medical Center (Lab)
Angel Primary Care
Appalachian Mountain Community H
Asheville Ear, Nose & Throat
Asheville Eye Associates
Blue Ridge Comm. Heath - Jackson
Blue Ridge Health-Pediatric Pulm
Blue Sky Pediatrics
BRH-Pediatric Neurology
Cares NC
Cherokee Indian Hospital Auth.
Clayton Family Medicine
Community Care Clinic of Frankli
Disabilities
Division Services of the Deaf an
Dr Tania Menz
Dr. Adam Burrell
Dr. Harrill Sharhonfa
Dr. Jason Creel
Dr. Jen-Jar Lin, M.D.
Dr. John Templeton
Dr. Judith Seago
Dr. Kevin Foley
Dr. Out Of State
Dr. Penelope O'Neil
Food And Nutrition Services
Franklin Eye Center
Franklin Police Department
Gossett, Daryl DO
Harris Family Care
Harris Pediatric Care
Harris Women's Care
Haywood Pediatrics
Hazelwood Healthcare
Health And Human Services Iowa
Health Coordinator
Healthy Opportunities Pilot Prog
Hendersonville Pediatrics
Jackson County Public Health
Jackson Medical Associates
John Templeton, MD
Kid's Place
Kidzcare Pediatrics
Kumar, Jai
Macon County Food ProgramWIC
Macon County Health Center
Macon County Schools
Macon County Social Services
Macon Family Medical Care
Macon Program For Progress
MAHEC
Medicaid
Medication Assistance Program
MedLink Georgia Inc
Mental Health Consultation
Mission Children's Clinic Ashevi
Mission Children's-Sylva
Mission Community Primary Care -
Mission Hospital
Mission My Care Now
Mission Primary Care
Mission Women's & Children's Cen
Mountain Area Health Ed. Center
Mountain Docs
Mountain Ear Nose & Throat, Ass
MPP-Screenings
Nandlal Chainani, MD
Nerissa Baker
Novant Health Pediatrics HC
Nurse Family Partnerships
Nutrition Supervisor
Peachtree Pediatrics
Rabun County Health Dept
Rutherford Physician Practices
Smokey Mountain Pediatrics
Smoky Mountain OB/GYN Associates
Smoky Mountain Pregnancy Care
Smoky Mountain Urgent care
Steinbicker, Natalie
Swain Family Care
Tadeusz Poplawski
Teresa Breedlove
Toledo, Charles
Vaya Health
Wake Forest/Brenner Children's H
Wal Mart Vision Center
Ward, Catherine DO
Wellspring
Western Carolina Physicians
Wilde, Gustav MD
Wolf, Sondra - Mtn Docs
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
ABC Dental Center
Appalachian Dental Associates
Asheville Pediatric Dentistry
Aspen Dental
Best Bites Dental
Blue Ridge Health Stokes Dental
Blue Ridge Pediatric Dentistry
Carolina West Dental
Cataloochee Dental Group
Charlotte Pediatric Dentistry/Bu
cherokee Indian Hospital Dental
Corbin Dental
DDS Out Of State
Dillard Dental
Dr. Dan Knechtel
Dr. David McGuire, DDS
Dr. David Oliver
Dr. Gerald Maize
Dr. Nathan Brenner
ECU School Of Dental Medicine
Everysmile Family Dentistry
Flossy Mountain Dental
Great Smiles
Haywood County Dental Office
John Edwards Family Dental
Larry Barbles DDS
Letitia L. Ballance, DDS
Magnolia Dentistry
Matthew Ricke, DDS
Mission Children's Dental
Molar Roller
Peachtree Children's Dentistry
Richard H. Vollmer, DDS
Smile Starters
smile starters Hickory
Smile Station Pediatric Dentistr
Tebo Dental
Western Carolina Family Dentistr
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?
How did you hear about us (Required)
Preferred Hospital (Required)
Hours Needed
9:00-3:00
9:00-3:00 and Bus
Extended Day
Location Preferences
Which program are you applying for? (Required)
Early Head Start 24/25
For children 6 weeks-2 years and pregnant women
Head Start Preschool 25/26
For children 3-5 years
Early Head Start 25/26
For children 6 weeks-2 years and pregnant women
Location Preference
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1st Location Preference
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2nd Location Preference
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3rd 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
Once you submit your application, please contact Tasha Rostallon by phone at (828) 524-4471 ext. 324, email trostallon@mppnhc.org, or by text message at 828-634-6776 to schedule your required in-person intake interview. An email with more information regarding the required documentation needed will be sent to you via the email address you provided on the application. Applications are considered incomplete until all required documents have been provided and an intake interview is completed. This means your child will not be placed on the waitlist until the application process is complete. We look forward to hearing from you!
Required information is missing, see above.