TRI-CAP Head Start

APPLICATION REQUIREMENTS

The following items are needed before completing the Head Start application process:

The Head Start Application

  • All sections must be complete. Application must be signed.

Your Child’s Birth Certificate

  • Children must be 3 or 4 years of age on or before August 1, 2016, or no more than five (5) years old after August 1, 2016.

Proof of Income

  • Must be bothparent/guardian’s last 12 months (a calendar year) income. Documents include a signed Income Form Tax 1040, W-2 forms, pay stubs, Unemployment Compensation, written statements from employers, or documentation showing current status as recipients of public assistance, Social Security Supplemental Income (SSI), TANF, or Child Support.

And, if your child has a diagnosed disability, please attach the Individualized Education Plan (IEP) or the Individualized Family Support Plan or evaluation report (IFSP).

All information returned to TRI-CAP Head Start will be maintained in a confidential manner.

TRI-CAP Head Start Program
Basic Information

We must be able to reach you in order to enroll your child.
If you move or change your phone number after completing this application, it is your responsibility to notify TRI-CAP Head Start.

Only a parent or legal guardian may sign this application.

You must provide proof of your child’s birth date by providing a copy of your child’s certified Birth Certificate.

You do not need to provide us with your child's Social Security Number (SSN) in order to be eligible for Head Start.

If your family is providing foster care for the child you are applying for, you automatically qualify for Head Start. You do not need to provide proof of income, but you must provide documentation that your family is currently providing care for a foster child.

If your family is receiving SSI or TANF, we will need a letter of proof along with all other income.

Please request an income declaration form if you or other primary guardian
had NO income over the past 12 months.

Head Start does not process applications on a first come-first served basis.
Please fill out the applications carefully as the information you provide will help us identify each family’s needs.
Children will be placed by priority.

If you have any questions regarding the application or enrolling your child, please call your local Head Start center and ask for the Head Start Family Advocate.

TRI-CAP Head Start Locations & Phone Numbers

Boonville/Tennyson: 812-897-0364

Newburgh/Chandler: 812-853-5928

Jasper: 812-482-2233

Petersburg: 812-354-8721

In accordance with Federal law and U.S. Department of Agriculture policy, this institution is prohibited from discriminating on the basis of race, color, national origin, sex, age, or disability. To file a complaint of discrimination, write USDA, Director, and Office of Civil Rights, 1400 Independence Avenue, SW, Washington, D.C. 20250-9410 or call (800) 795-3272 or (202) 720-6382 (voice and TTY). USDA is an equal opportunity provider and employer.

Funded by U. S. Dept. of Health & Human Services