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Form Testroark2021-01-07T07:50:24-08:00

Head Start/ECEAP/Early Head Start Initial Application - V6

Thank you for your interest in our program for young children. Please complete the following form to begin the application process.

Step 1 of 8 - About Your Child

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  • Initial Application

    • All applications for enrollment in our program go through a detailed selection process that helps us to select children and families with the highest need of our services.
    • This selection process will begin in early summer and continue until classes are full.
    • Should your child not be selected, they will be placed on a waiting list. This will not guarantee you a slot this year, but it will leave the possibility open as vacancies occur.

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  • About Your Child

  • This means there is a caregiver authorization form fro a state or tribe that says this is a foster care placement.
  • e.g. Molina, Community Health Plan
  • (i.e. Lummi Nation Head Start, Nooksack Tribal Head Start, etc.)
  • ELAFS serves children with behavior issues. Checking yes will not exclude your child
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  • About Your Family

  • Please enter a number greater than or equal to 1.
  • Please enter a number greater than or equal to 0.
  • Please enter a number greater than or equal to 0.
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  • About You

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  • Household Info

    This is required information
  • NameRelationshipDate of Birth 
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  • Health and Social Services Information

  • (Health Department, Brigid Collins, etc.)
  • Low-Income Housing or Section 8
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  • Concerns and Challenges

  • Select all that apply to you or your family.
  • Homeless is defined as sharing the housing of other persons due to loss of housing or economic hardship; are living in motels, hotels, trailer parks, or camping grounds due to lack of alternative adequate accommodations; are living living in emergency or transitional shelters (McKinney-Vento Homeless Assistance Act)
  • This may qualify you for additional program supports.
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  • Certification

  • Type name to certify
  • Optional - Verification of Age and Income File Upload

    If scanned copies are unavailable, Verification of Age and Income can be mailed or submitted in person. Your application will not be complete until all items have been received.
  • Either the last 12 months or the last calendar year.
  • Birth Certificate or Hospital Certificate
  • This field is for validation purposes and should be left unchanged.
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Whatcom County

1111 Cornwall Ave.
Bellingham, WA 98225
(360) 734-5121
(800) 649-5121
Admin Fax (855) 224-7921

American Sign Language 

Island County

231 SE Barrington Dr. Suite 100
P.O. Box 922
Oak Harbor, WA 98277
(360) 679-6577
(800) 317-5427
Fax (855) 952-2016

San Juan County

(800) 649-5121

Partner Links

Community Resource Guide

Whatcom Asset Building Coalition

AmeriCorps-VISTA Program

East Whatcom Regional Resource Center

Whatcom Volunteer Center

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