Early Childhood Enrollment Applications
You will need Adobe Acrobat Reader to open the links on this page. If you do not have Adobe Acrobat Reader installed, click the Get Acrobat link below to download.

EARLY CHILDHOOD PROGRAM APPLICATION
PRENATAL EARLY HEAD START APPLICATION
Things to bring for enrollment:
- Proof of Income
(i.e. Pay stubs, W-2 form, 1040 tax form, child support information, social security benefits, unemployment information, written statement from employer)
- Copy of any legal custody/guardianship papers
(if applicable)
- Proof of Medical Insurance for child applying
(i.e. Private insurance, Ohio Medicaid/Healthy Start) (if applicable)
- Copy of the applying child’s birth certificate
- Copy of the applying child’s social security card
- Copy of the applying child’s immunization record
(If you cannot locate a copy of your child’s immunization record, please complete a release form with our office.)

|