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About / How to Apply
Early Childhood Enrollment Applications
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EARLY CHILDHOOD PROGRAM APPLICATION : http://www.pikecac.org/EarlyChildhood/EARLY_CHILDHOOD_PROGRAM_application_REVISED_05-03-12.pdf
PRENATAL EARLY HEAD START APPLICATION : http://www.pikecac.org/EarlyChildhood/EARLY_CHILDHOOD_PROGRAM_application_REVISED_05-03-12.pdf
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’
The Early Head Start Program is a developmental program providing services for pregnant women andfamilies with children birth to three years old, including services for children with special needs, whomeet 100% of the…
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Please do not submit: Social Security numbers, birth certificates, income or tax documents,
medical records, immigration documents, benefit-account details, or other official application materials through
this form. Official enrollment documents must be submitted directly to the local Head Start program.