Eligibility & Registration
2022/2023 Head Start Enrollment Checklist
*Pre-registration does not guarantee enrollment
To process the application, you must bring the following documentation along with the application packet.
- Birth Certificate for child (3, 4, or 5 years of age)
- 2022 Income Tax or W2 forms if not filed
- Last pay stub from employer (if employed in different jobs, must bring pay check stubs from all jobs, including spouse)
- If receiving unemployment, must bring in all stubs or report for the past 12 months (EDD Report)
- Passport of Services; if receiving financial assistance (TANF/Cal-Works)
- If you are receiving child support: Bring proof for last 12 months from child support office or court ordered paperwork
- If you are a single parent, not receiving child support we need the absent parent’s income
- Social Security letter with amount received monthly
- Proof of Residency (current utility bill, rental agreement, etc.)
- Immunization Record
- Copy of complete Physical Exam (with TB clearance, Lead and Hemoglobin results) for child enrolling (valid for 12 months)
- If your child has any Allergies or Medical Conditions, we will need the following:
- Physician Information (name, phone number, and address)/ Care Plan
- If under medication, Consent for medication form needed (see Health Technician for form)
- Complete medical statement by physician (see Health Technician for form)
- If your child has an IEP (Individualized Education Plan): Please Bring Copy
- If you have an Active Restraining Order: Must Bring a Copy
Our program does not discriminate children who are not potty-trained.
2021/2022 Head Start POVERTY GUIDELINES FOR THE 48 CONTINUOUS STATES AND THE DISTRICT OF COLUMBIA
(Income over $ amounts do not qualify)
|FAMILY SIZE||FAMILY ANNUAL INCOME|
For families with more than 8 persons, add $4,720 for each additional person.
For Additional Information, Please Contact our Office at: 760-922-8454
This program operates on a nondiscriminatory basis and gives equal opportunity to service without regards to race, sex, creed, religion, national origin, ancestry or legal status.