Language
  • English (US)

  • Early Head Start/Head Start Application 2022-2023

  •  About the Program/Important Information

    • Scott Carver Dakota CAP offers two programs:
      • Early Head Start is a free, weekly home visiting program for pregnant parents and children age birth to 3 years old. Focus is on parent-child relationships and healthy development.
      • Head Start is a free preschool class for children ages 3-5 years old. Half- and full-day options available. Meals/snacks are provided; families are responsible for transportation. Focus is on kindergarten-readiness.
    • In accordance with federal rules, eligibility is based on family income.
    • Completion of this application does not guarantee acceptance or immediate start date. Information is optional; however, incomplete or inaccurate information may prevent us from determining your eligibility.
    • To complete your application, please submit your child's birth certificate and documentation to support income eligibility (see last page).
    • If you need help completing this application, please call 651-322-3500. Hearing impaired use MN Relay Service 1-800-3529.

  • Applicant/Child Information

  •  /  /
    Pick a Date

  • Health Information

  • Education, Disability, & Behavior Concerns

  • Program Preference

  • Scott-Carver-Dakota CAP offers three programs:

    • Early Head Start - Prenatal
      • 90 minute home visits, every two weeks, provided in-home for expecting parents
    • Early Head Start - Age Birth-3yrs
      • 90 minute weekly home visits, provided in-home
    • Head Start
      • Preschool class for children ages 3-4yr11m years old. (Age is the age of the child on September 1st of the program term)

     

    Applications are accepted on a rolling basis.  At this time you may apply for 2021-2022 (start soon, as space allows) and/or 2022-2023 (start late-August/September 2022).

  •  -  -
    Pick a Date
  •  -  -
    Pick a Date
    • Click here to add a second applicant/child  

    • Applicant/Child #2 Information

    •  -  -
      Pick a Date

    • Health Information

    • Education, Disability, & Behavior Concerns

    • Program Preference

    • Scott-Carver-Dakota CAP offers three programs:

      • Early Head Start - Prenatal
        • 90 minute home visits, every two weeks, provided in-home for expecting parents
      • Early Head Start - Age Birth-3yrs
        • 90 minute weekly home visits, provided in-home
      • Head Start
        • Preschool class for children ages 3-4yr11m years old. (Age is the age of the child on September 1st of the program term)

       

      Applications are accepted on a rolling basis.  At this time you may apply for 2021-2022 (start soon, as space allows) and/or 2022-2023 (start late-August/September 2022).

    •  -  -
      Pick a Date
    •  -  -
      Pick a Date

  • Primary Parent/Guardian Information

  •  /  /
    Pick a Date
  •  -  -
    Pick a Date
    • Click here to enter information for second parent/guardian or other adult.  

    • Second Parent/Guardian or Other Adult

    •  /  /
      Pick a Date
    •  -  -
      Pick a Date

  • Other Household Members

  • Please list all others living in the home, not included above.

  •  /  /
    Pick a Date
    • Add another?  
    •  /  /
      Pick a Date
    • Add another?  
    •  /  /
      Pick a Date
    • Add another?  
    •  /  /
      Pick a Date
    • Add another?  
    •  /  /
      Pick a Date

  • Family Information

  • Income Types

  • The federal Office of Head Start sets program eligibility standards.  The following questions help to determine income eligibility.

  • To verify income eligibility, please submit documents to show the above income.

    Examples include: copies of prior year W2 or Federal Income Tax Forms, 3 months of pay stubs, Unemployment deposit slips, MFIP award letter, SSI verification, child support or alimony documents, foster care placement form, etc.

    Please also submit a copy of your child's birth certificate.

    Your application cannot be completed until we have received these documents.

     

    To submit, you may:

    • attach these documents below,
    • email to headstart@capagency.org, 
    • fax to 651-322-3555, or
    • mail/drop-off at 2496- 145th St W, Rosemount, MN 55068

     

     

  • Browse Files
    Drag and drop files here
    Choose a file
    Cancel of

  • Submit

  • Your right to privacy is protected by the federal Privacy Act of 1974 and the Minnesota Government Data Practices Act. Private information included on this application will be used to determine your program eligibility and to guide program services. Information may be shared with government agencies, including the Office of Head Start and MN Department of Human Services. You are not required to provide this information. However, failure to answer the questions may impact our ability to determine your program eligibility.

    I certify that the answers given are true and complete to the best of my knowledge. I agree to contact CAP Head Start if the information changes.

  • Clear
  • Should be Empty: