TO PROCESS YOUR HEAD START APPLICATION, THE FOLLOWING INFORMATION IS NEEDED:

• Birth Certificate - a copy is required.
• Immunization Record -(if child has not been immunized, you must see the doctor first).
• Income records from most recent full tax year (W2, tax return, public assistance)
• Most recent proof of income (check stub, child support record, public assistance statement, etc.)
• T.A.N.F. (current 12 months printout).
• Medicaid or Hoosier Health Wise number for child and primary adult.
• Child Support (current 12 months printout).
• Private Insurance name and number if child is covered under a family plan.
• Name, address and phone numbers of Childs medical and dental doctors.
• 3 Emergency Contacts: names, valid & working phone numbers and addresses.