Registration 

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• Registration Application: (create an account and complete for each child you are interested in enrolling)

• Head Start Application: for ages 6 weeks-5 yrs old only (create an account and complete for each child you are interested in enrolling)

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Household Information

 

•  Household Composition Form 

 

Exams/Releases

• Medical Authorization to Release Information Form 

• Completed Child Examination Form (6 weeks – 5 yrs.) Required screenings and shot records

 

• Dental Authorization to Release Information Form 

• Completed Dental Examination Form (2½ yrs. – 5 yrs.)

 

 

Income Verification (Most Recent 30 Days)

 

• Pay Check Stubs

                                     or

• Statement from employer on company letterhead (state date, pay rate, schedule)

                                    or

• Self-Declaration Affidavit Form

                                    or

• Proof of unearned income (ex: OWF, SSI, temporary disability, unemployment, SNAP ) 

                                    or

• Zero Living Expense Statement Form 

 

Schedule (If applicable)

 

•  Work/School Schedule on company letterhead or a work verification form 

 

Child's Age Verification

 

• Birth Certificate

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Parent/Guardian Identification

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• Valid picture I.D

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Childcare Benefits Application

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• Initial Application- Needed if you do not currently have childcare benefits

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• Placement Form- Needed with your initial application and if you currently have benefits and are requesting a change in placement

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