Below are two applications for enrollment: Early Head Start (for ages 6 weeks to 3 years)
and Head Start (for ages 3 years to 5 years). 

Please supply the information requested, or contact us if you have any questions.


--- EARLY HEAD START ---
Enrollment Application
 
Primary Adult's Name
Date of Birth:             Year:
Address:
City:     
Zip Code:
Phone:
Email Address:
Center Applying to:
Child's Name
Date of Birth:         Year:

    


--- HEAD START ---
Enrollment Application
 

Primary Adult's Name
Date of Birth:       Year:
Address:
City:      
Zip Code:
Phone:
Email Address:
Center Applying to:
Child's Name
Date of Birth:        Year: