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.





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