Head Start/Early Head Start Application |
1. Application MUST be completed entirely. An incomplete application may delay processing.
1. Please send proof of your child's birth date.
- Birth Certificate OR Medicaid Card (child's name and birthday must be legible)
2. Please send proof of categorial eligibility.
- Placement documentation for children in foster, relative or non-relative care.
- Proof of SNAP, TANF, or SSI Benefits
- McKinney-Vento & Living Situation Survey
If your family has documentation of at least ONE items stated in number 2, you may skip number 3.
3. Send proof of your family income for the last calendar year or the past 12 months.
3. Send proof of your family income for the last calendar year or the past 12 months.
- Income Tax Form (1040, 1040A)
- W2 Form for the past year
- Employer letter stating total gross earnings for the past 12 months.
- A December pay stub showing the year-to-date earnings.
If you have any questions, please contact:
Michelle Myers
Family Service/ERSEA Coordinator
michelle@tricountyheadstart.com
(850)548-9900 ext. 108