Quick Application

Thank you for your interest in LCCAA's Head Start or Early Head Start preschool program.

Head Start is a school readiness program serving students 3 to 5 years old. We offer center, school and home-based options.

Early Head Start provides services to pregnant women, infants, and toddlers.

Families who live at or below 130% of the federal poverty line are eligible. Foster families and families considered to be homeless also qualify for the program.

Families are also eligible if they are receiving Temporary Assistance to Needy Families (TANF), Supplemental Security Income (SSI), or Supplemental Nutrition Assistance Program (SNAP).

The program allows for placement of a limited number of children who are over-income.

The application below begins the process of enrollment. A Family Service Assistant or Home Visitor will contact you for additional information, documentation, and to complete other forms.

Student Information

(select if a sibling in the household is currently enrolled in the program)

Household Information

Note: if this child is a dual-custody child, enter the number of adults in both households combined
Note: if this child is a dual-custody child, enter the number of children in both households combined

Guardian #


Guardian #



(Directly Operated)

(Collaborative Partners)

Family Income