If you wish to complete an application ONLINE – click on these links:

If you wish to PRINT a copy on your own printer in PDF format – click on these links: (You can then complete the form by hand, and mail it back to us, or drop off in person)


Families with infants and toddlers under the age of 3 are eligible for Early Head Start. In addition, children and families must also fit into at least one of the following categories:

  • Families with incomes below the Federal poverty level.
  • Families eligible for Child Care Assistance, the Temporary Assistance for Needy Families (TANF) program, or the Supplemental Security Income (SSI) program.
  • Children who are experiencing homelessness, who are in the child welfare system, foster care, or who have a disability.