Families First of Minnesota Head Start & Early Head Start
126 Woodlake Drive SE Rochester MN 55904
Submission of Additional Income Info Form
Please use this form to submit additional income related documents to go along with your original application. These documents or statements have been deemed necessary to verify eligibility.
Acceptable document formats for uploading/submitting here are: pdf, doc, docx, xls, xlsx, csv, jpg, jpeg, png, gif
Please note, income eligibility guidelines are established for participation Head Start programs based on the poverty guidelines updated annually by the US Department of Health and Human Services Grantees are required to verify family income documents such as pay stubs, or W-2s to determine if the child/woman is income eligible. As is the case with those categorically eligible, we are required to retain a record of the documents reviewed and relied upon to determine that a child is income eligible accompanied by a statement signed by an employee of the Head Start grantee that the child was found to be eligible.
Please fill in as much as you can - this will help us match everything up!