Early Head Start
By completing this form, it does not mean your child is registered for the Early Head Start Program. This form is used as a "Recruitment Form". For the application to be processed, we will also need: Copy of Child's Birth Certificate Verification of Family Income for the past year (i.e. consecutive pay stubs, W-2, etc) Proof of Residency Any Family Court documents relative to your Child
This website is supported by Grant Number 02CH012141 and 02CH011631 from the Family and Youth Services Bureau within the Administration for Children and Families, a division of the U.S. Department of Health and Human Services. Neither the Administration for Children and Families nor any of its components operate, control, are responsible for, or necessarily endorse this website (including, without limitation, its content, technical infrastructure, and policies, and any services or tools provided). The opinions, findings, conclusions, and recommendations expressed are those of the author(s) and do not necessarily reflect the views of the Administration for Children and Families and the Family and Youth Services Bureau.