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Welcome!
Head Start is a national child development program that serves families with children from birth to age five, and expectant parents. The program is designed to prepare children for success in school by enhancing their intellectual, social, emotional, and physical development. This service is provided at no cost to eligible families. Your family may be eligible for Head Start services if your family's income is determined to be at, or below, poverty level. Families are selected based on need. Programs may enroll some children from families whose incomes are higher than the federal poverty level if they meet other eligibility requirements. Families with circumstances such as homelessness, children in foster care, or receiving TANF, SNAP, or SSI also qualify for services. Families must provide proof of income, proof of residency, and proof of age.

Please note: The application is the first step of the process. Not all families who apply are eligible for services. Your application is not complete until we:

-- Verify residency in Fairfax County within our service area of Falls Church, Annandale and parts of Springfield
-- Complete a phone interview and
-- Verify income, residency and birth information.

Here is a list of documents to gather. You can upload copies for staff to review on the next screen.
-- Income: 1040 and W2s (and Schedule C if self-employed), two recent consecutive pay stubs, a form filled out by your employer, or your TANF / SNAP / SSI benefit letter.
-- Child's Age: Birth certificate, current passport, or other proof of birth, such as a hospital letter.
-- Residency: Utility bill (gas, electric, water), lease, deed, mortgage statement, or rental agreement.

Fill out the information below if you are interested in applying for the Head Start/Early Head Start program.

If you have additional questions, please contact our main office at 703-820-2457.

Please complete as many fields as possible in order to help us process your application. Make sure you have included a phone number where we may reach you to follow up on your application to this program.

First Name (Required)

Middle Name

Last Name (Required)

Suffix

Birthday (Required)

Gender (Required)

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 (Required)

Opt In for Text Messages

Home Phone (Required)

Work Phone (Required)

Ext.

It appears that you have previously submitted an application. If you wish to apply again, please contact us by phone or in person.

SSN

Race (Required)

Hispanic (Required)

Lives with Family (Required)

English Proficiency (Required)

Other Language

Other Language Proficiency

Highest Grade Completed (Required)

Employment Status (Required)

Child's Relationship (Required)

Custody (Required)

Provides Financial Support (Required)

Teen Parent

If Teen Parent, Subsidized?

When filling out your living address, please include apartment number, if applicable.

Is your family experiencing homelessness?

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

Is there another parent/guardian in the family?

First Name (Required)

Middle Name

Last Name (Required)

Suffix

Birthday (Required)

Gender

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

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.

SSN

Race

Hispanic

Lives with Family

English Proficiency

Other Language

Other Language Proficiency

Highest Grade Completed

Employment Status

Child's Relationship

Custody

Provides Financial Support

Teen Parent

If Teen Parent, Subsidized?

Are there other adults in the household?

Add Another Adult

Number of Parents/Guardians (Required)

Relationship to Participant(s) (Required)

Primary Language at Home (Required)

Is another language being acquired or learned at home?

Number in Household (Required)

Number in Family (Required)

Is your family receiving cash benefits or other services under the Temporary Assistance for Needy Families (TANF) program? (Required)

Is your family receiving Supplemental Security Income (SSI)? (Required)

Is your family receiving services from WIC? (Required)

WIC ID (if applicable)

Is your family receiving services under the Supplemental Nutrition Assistance Program (SNAP), formerly referred to as Food Stamps? (Required)

Is at least one parent/guardian an active duty member of the United States military?

Is at least one parent/guardian a veteran of the United States military?

Add Emergency Contact

First Name (Required)

Middle Name

Last Name (Required)

Suffix

Nickname

Birthday (Required)

Gender (Required)

SSN

Race (Required)

Hispanic (Required)

Lives with Family

English Proficiency (Required)

Other Language

Other Language Proficiency

Primary Health Coverage (Required)

Other Coverage

Insurance Number

Medicaid Eligibility

Medicaid Number

Doctor/Medical Home

Dental Coverage

Dental Coverage Number

Dentist/Dental Home

Does your child have a disability or do you have any concerns about your child's development? (Required)

Is there anything else you want to tell us about your child?

Referral Source (Required)

Which program are you applying for? (Required)

Location Preference

1st Location Preference

2nd Location Preference

3rd Location Preference

- Your Address - Available Locations

Click a location on the map to see more info

Click here to find a provider in your area.

Do you want to apply now for another child in your family?

Add Another Applicant

Are there other children in the family?

Add a Sibling

Required information is missing, see above.

Parent/Guardian

Address

Additional Parent/Guardian

Other Adults

Family Information

Emergency Contacts

Child (Applicant)

Location Preferences

Additional Applicant

Siblings