Kids on Campus - Head Start Screener

HEAD START INTEREST FORM

The Kids on Campus initiative is a collaboration between the Association of Community College Trustees (ACCT) and the National Head Start Association (NHSA). Our mission is to enhance access to affordable, high-quality early education for student parents by increasing the number of Head Start programs located on community college campuses. This partnership benefits both community colleges and Head Start programs and sets a precedent for cross-sector collaborations that support students and families holistically.

This form is designed to gauge your Head Start program’s interest and capacity to pursue a Kids on Campus partnership. Please complete it if you are a Head Start director or staff member who can communicate with decision-makers and is familiar with your center’s capacity, needs, and funding sources, or can collaborate with those who are.

Note: Submitting this form does not obligate your program to participate.

If you represent a Head Start Grantee or a program with multiple centers interested in this initiative, please contact us directly at kidsoncampus@acct.org to discuss relevant information for all involved programs.

Your responses will help us understand your program's interest and readiness to explore this partnership and initiate conversations with potential partners. If you have any questions, feel free to reach out to us at kidsoncampus@acct.org.

(1) What is your name?*

First NameLast Name

(2) What is the name of your Head Start?*

(3) What is your job title?*

(4) What is your work e-mail address?*

example@example.com

(5) What is your Head Start's address?*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

(6) Have you previously had conversations with, or are you in current conversations with, a community college about establishing a center on their campus?*

Yes, we have previously had conversations with a community collegeYes, we are in current conversations with a community collegeNo, we have not had conversations with a community collegeI am not sure

What is the name of that community college?

When was the last time you were in touch with that community college?

Who did you communicate with?

(7) Has your Head Start previously partnered with a community college for space on that campus?*

YesNoI am not sure

What is the name of that community college?

When was the last time you were in touch with that community college?

Who did you communicate with?

(8) How many Head Start classrooms does your program operate?*

(9) What is your program's total funded enrollment?*

(9a) Of the program's total funded enrollment slots, how many of those are Head Start (3-5 year old) slots?*

(9b) Of the program's total funded enrollment slots, how many of those are Early Head Start (0-3 year old) slots?*

(9c) Of the program's total funded enrollment slots, how many of those are funded by other sources?*

(10) Please describe the current ownership/leasing status of your center(s) space. (check all that apply)*

We own the entire buildingWe lease or rent the entire buildingWe have an entire building donated for our useWe have part of a building owned, leased/rented, or donated

(11) Are you, as a Head Start grantee or program, actively looking for new Head Start space?*

YesNoI am not sure

Please explain why you are actively looking for new space. What are you currently looking for? Please include and describe any impending deadlines, major building repairs need, and/or other relevant information.*

(12) Are there other reasons for your Head Start's interest in partnering with a community college? (check all that apply)

Access to campus resources (facilities, staff, admin service, HR, etc.)Increase enrollmentUpskilling and training for Head Start staffAccess to campus resources and course/training for Head Start familiesFoster a Head Start workforce pipeline

(13) Does your Head Start collect data on parents or guardians of enrolled children attending the local community college(s)?*

YesNoI am not sure

(14) Does your Head Start collect data on parents or guardians of enrolled children interested in furthering their education or training?*

YesNoI am not sure

(15) Are there any additional details you would like to share with us?