Apply

Contact us to find out more about our programs, and discover if you and your child or family are eligible for enrollment.

Choose your preferred way to contact us: by email, print form, telephone, or walk-in!

Then gather this information:

Email Form

To learn more about our programs via email, please fill out the form below and submit. A Head Start representative will contact you with further information.

YOUR NAME *

First

Last

Your Relationship to CHILD (Parent, Guardian, etc.)

Name of CHILD *

First

Last

Date of CHILD'S BIRTH *

Your Address

Address Line 1

Address Line 2

City

State

Zip Code

Your Phone Number *

Your Email *

Your Primary Language *

Proficiency in English Language *

Do comfortably speak / understand English?

Choose the PROGRAM you are interested in

Early Head Start (prenatal to 2.9 years)
Head Start (2.9 years to 5 years)
Migrant/Seasonal Head Start (prenatal to 5 years)

Message

Mail or Drop Off Form

To find out about our programs using a hard copy form:

Click on the image below. It will open in a new window.
Right-click to download/save and print the form.
Fill it out
Submit in person, by mail, or by fax.

Phone Contact

To find out about our programs by phone, please call our Head Start Family Center office at (413) 417-7779.

Walk-In

Come into one of our Enrollment Centers and speak to a staff member.

Holyoke Enrollment Center
662 High Street
Holyoke, MA 01040

Springfield Enrollment Center
Suite 204, 130 Maple Street
Springfield, MA 01103

You will need:

Records of your child’s current physical, and immunizations

Child’s age verification (birth certificate)

Health Insurance Card

IEP/IFSP (if applicable)

Custody Documentation (If applicable)

Plus ONE of these:

Current proof of public assistance: SSI or TAFDC letter dated within 30 days OR

Proof of family income for the past year including: paystubs, tax return, W-2’s, letter from employer, child support statement or notarized letter (dated within 30 days) OR

Proof of receiving SNAP OR

Proof of homelessness or foster care

Apply

Email Form

Mail or Drop Off Form

Phone Contact

Walk-In