New Application

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Welcome to the Head Start program application!

This application has two parts and may take approximately 20 – 40 minutes to complete.

Please note that both parts of the application must be completed before your application can be processed.

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  1. Parent/Guardian 1
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    5. One Parent / Guardian must live with child
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  2. Parent/Guardian 2
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    5. One Parent / Guardian must live with child
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  4. * For children who do not have a developmental delay or disability, household income and vulnerability are considered for program eligibility. The income and vulnerability criteria were established to recognize the need for Head Start programming for families where other factors in addition to income may create barriers to success in learning and in life.
  5. Please choose all that apply
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Please include copies of the required Eligibility Documents with your submission:

  • Child’s Alberta Health Care Card
  • Child’s Birth Certificate or Passport or Adoption Order
  • Child’s Citizenship Papers (If your child is not a Canadian citizen you will also be required to provide a copy of your citizenship papers and work or student visa)
  • Copy of Guardianship orders (if applicable)
  • All diagnosis and assesment documents (if applicable)

We also require proof of low income eligibility. Any of the following documents are acceptable:

  • Child Health Benefit Card
  • Leisure Access Pass
  • Income Support Document
  • Notice of Assessment or T4 or letter of employment or recent paystubs (60 days or 2 months) or Confirmation of Adult Student Status or Self-employment documents
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  2. The information provided in this document is true, correct and complete. I have identified all parents and legal guardians for this child. The individuals identified in the “parent/legal guardian” section have the right to view child information and make educational decisions for this child, unless otherwise indicated here and supported with legal documentation. Further, I recognize that it is my responsibility to notify A B C Head Start Society should the above information change.

    In accordance with the Freedom of Information and Protection of Privacy Act (FOIP), I accept A B C Head Start Society is authorized and required under the provisions of the School Act and its regulations to collect, use and disclose personal information that is necessary to provide educational programming and ensure a safe and secure environment for children.

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  1. This section to be completed ONLY by referring agency following parental consent

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