Family Development Services
 
 

Please complete this form to begin the Head Start application process. All fields marked with an * are required. If you have questions, look at our FAQ, or contact us.

Pre-Enrollment Form

    Program





    Program Preference

    Head Start: 7 hour (M-F8:30am - 3:30pm)
    Head Start: 9 hour (M-F8:30am - 5:30pm)

    Applicant Child:













































    Primary Adult:


























    *Check all that apply for this adult

    Lives with FamilyProvides Financial SupportTeen Parent




    Secondary Adult:


























    *Check all that apply for this adult

    Lives with FamilyProvides Financial SupportTeen Parent




    Family Information





















    Primary Adult



































    Second Adult



































    Other Non-Applicant Children in Family



















































    Please answer the following questions:








    Parent/Guardian Consent

    *I certify that all information provided on this application is accurate to the best of my knowledge.





    captcha

    Please enter the characters above.