• 2022-2023 Head Start Application

  • Welcome!

    Please complete one application per child and attach the required documents at the end of this application form. 

    Please note: This application is for the 2022-2023 school year to begin in the Fall of 2022. If you are looking to apply for the CURRENT school year, you can find the 2021-22 application on the Edwin Pratt ELC homepage. 

    Eligibility to our programs is determined by child’s age and family income, not by the date you applied. The information on your application is confidential and used only to determine your child’s eligibility for our Early Learning Programs. We do not require, check, or report on immigration or DSHS status.

    Please allow yourself plenty of time to complete the application. You will be asked to upload the following required documents at the end. Please have them ready.

     If you have any difficulties locating or obtaining any of the requested documents, please call our main office and ask to speak with a family advocate at (206) 393-4350.  You can still complete and submit the application, however your child's application will be considered for enrollment only after all documents are received and approved. 

    Required Documents:

    Proof of Income - use all that apply:

    • 2021 Tax Return
    • 2021 W-2 form
    • Paystubs for the last 12 months
    • SSI/TANF benefits letters for the last 12 months
    • Foster Care Grant
    • Child Support
    • Employer letter stating total gross income from last 12 months

    Proof of Family Size - us one of these:

    • 2021 Tax Return that lists all members of the family
    • Lease or Rental Agreement that list all members of the family
    • Recent TANF/SSI/EBT benefit letters that list all members of the family

    Proof of Child’s Age - use one of these:

    • Birth Certificate
    • Passport/Visa
    • Adoption Papers
    • Foster Care Authorization Letter
    • Current Immunization Record
    • DOC Residential Parenting Roster

    Proof of Legal Guardianship - use one of these:

    • Birth Certificate
    • Passport/Visa
    • Adoption Papers
    • Foster Care Record
    • Written agreement signed and dated by parent and person assuming custodial responsibility

    Proof of Residency - use one of these:

    • Property Tax bill
    • Current Mortgage Statement
    • Unexpired Lease Agreement
    • Utility Bill dated within the last 3 months (water, sewer, gas, electric, or garbage)
  • Child Information - General

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  • The questions below are for information only.  Answering "Yes" will not affect your eligibility or enrollment in the program.

  • Child Information - Health

  • Child Information - Development

  • Parent/Guardian Information

  • Parent/Guardian 1

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  • Parent/Guardian 2

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  • Family Concerns

  • Family Living Situation

  • Family Income and Family Size

  • Please list additional people living in this child's primary household below, NOT including yourself or this child.

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  • Early Learning Application 2022-2023

    I promise that the information on this form is true and correct. I have reported all my income and family size, as required by the Early Learning Programs. If I knowingly provide false information, I understand my family may be unable to continue program services. Additionally, if my child is enrolled in ECEAP, I may have to repay the amount spent on my child.

    I understand that information from this application is entered in various Early Learning databases operated by the Department of Children, Youth, and Families (DCYF) and Puget Sound Educational Service District (PSESD DCYF and PSESD are committed to protecting confidential and personal information that could identify a child or family. No information related to immigration status is entered in the databases or shared with state or federal agencies. Information in the databases may be used for the following:

    • Research studies to determine if participating in Early Learning helps children later in life.
    • To prove Washington State spends some of their own dollars on programs for families, which is required to receive Temporary Assistance for Needy Families dollars from the federal government.
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  • Early Learning Application 2022-2023

    Document Upload
  • If you have any difficulties locating or obtaining any of the requested documents, please call our main office and ask to speak with a family advocate at (206) 393-4350.  You can still complete and submit the application, however your child's application will be considered for enrollment only after all documents are received and approved. 

    Required Documents:

    Proof of Income - use all that apply:

    • 2021 Tax Return
    • 2021 W-2 form
    • Paystubs for the last 12 months
    • SSI/TANF benefits letters for the last 12 months
    • Foster Care Grant
    • Child Support
    • Employer letter stating total gross income from last 12 months

    Proof of Family Size - us one of these:

    • 2021 Tax Return that lists all members of the family
    • Lease or Rental Agreement that list all members of the family
    • Recent TANF/SSI/EBT benefit letters that list all members of the family

    Proof of Child’s Age - use one of these:

    • Birth Certificate
    • Passport/Visa
    • Adoption Papers
    • Foster Care Authorization Letter
    • Current Immunization Record
    • DOC Residential Parenting Roster

    Proof of Legal Guardianship - use one of these:

    • Birth Certificate
    • Passport/Visa
    • Adoption Papers
    • Foster Care Record
    • Written agreement signed and dated by parent and person assuming custodial responsibility

    Proof of Residency - use one of these:

    • Property Tax bill
    • Current Mortgage Statement
    • Unexpired Lease Agreement
    • Utility Bill dated within the last 3 months (water, sewer, gas, electric, or garbage)
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