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Head Start/ECEAP/Early Head Start Initial Applicationjavier2023-05-15T12:51:21-07:00

Head Start/ECEAP/Early Head Start Initial Application - V8

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

Step 1 of 8 - About Your Child

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  • Hidden
    Field used to track if applicant reached site via a recruitment event

  • 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. We continue to accept children throughout the year as vacancies occur.
    • If your child is selected for enrollment, you will receive a letter in the mail no later than August 31, 2023. This letter will inform you of what the next steps are to complete the enrollment process.
    • 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 from 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.)
  • Is this child's family actively involved in and/or receiving support from Tribal or State Systems including Child Protective Services (CPS), Family Assessment Response (FAR), Indian Child Welfare (ICW), comparable Tribal services or Law Enforcement/court system regarding child abuse, neglect, or sexual assault?
  • ELAFS serves children with behavior issues. Checking yes will not exclude your child
  • This child was previously enrolled in:
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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

  • Do you need an interpreter to communicate with English speaking staff?

  • Do you need an interpreter to communicate with English speaking staff?
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  • Household Info

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

  • (No IEP, diagnosis, or screening, or completed developmental screening with result, "rescreen needed."
  • Including CPS/FAR/ICW services, or comparable tribal service, or been involved with law enforcement/court system regarding child abuse, neglect or sexual assault?
  • (Health Department, Brigid Collins, etc.)
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  • Concerns and Challenges

  • *Homelessness refers to a state in which individuals lack a fixed, regular, and adequate nighttime residence, including children who are sharing housing of other persons owing to loss of housing, economic hardship, or similar reason (living in motels, hotels, trailer parks, or camping grounds owing to lack of alternative adequate accommodations; living in emergency or transitional shelters or abandoned in hospitals, cars, parks, public spaces, abandoned buildings, substandard housing, bus or train stations). Homelessness may apply to migrant children under certain circumstances. NOTE: This is a definition used by federal, state, and local educational institutions (e.g., Head Start/Child Care, PART C and Part B).
  • This may qualify you for additional program supports.
  • When selecting families for our programs, all information provided is kept confidential.
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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.
    Max. file size: 25 MB.
  • Birth Certificate or Hospital Certificate
    Max. file size: 25 MB.
  • This field is for validation purposes and should be left unchanged.
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