NEW Head Start
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  • Head Start Application

    2026–27

  • Student Information

  • Student's date of birth*
     - -
  • Student's preferred language*
  • Does the student speak English at home?*
  • Is the student Hispanic, Latino, or of Spanish origin?  Hispanic, Latino, or of Spanish origin means a person of Cuban, Mexican, Puerto Rican, Central or South American, or other Spanish culture or origin, regardless of race.*
  • Select one or more races from the following five racial groups. Please check all boxes that apply to your child; check at least one box.*
  • Is the student a U.S. citizen?*

  • Parent/Guardian Information

  • Parent/Guardian's date of birth*
     - -
  • Is the Parent/Guardian receiving WIC?*
  • Does the Parent/Guardian receive SNAP/Food Stamps?*
  • Parent/Guardian's preferred language*
  • Is the Parent/Guardian Hispanic, Latino, or of Spanish origin?  Hispanic, Latino, or of Spanish origin means a person of Cuban, Mexican, Puerto Rican, Central or South American, or other Spanish culture or origin, regardless of race.*
  • Select one or more races from the following five racial groups. Please check all boxes that apply to the Parent/Guardian; check at least one box.*
  • Parent/Guardian's employment status*
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  • A valid cell phone number and email address are necessary for full functionality of ParentSquare, our school-to-family messenger app. If you do not provide this information, you may miss important messages from the school.

    Many companies (Google, Yahoo, etc.) provide email addresses free of charge.

  • Format: (000) 000-0000.
  • Parent/Guardian's marital status*
  • Family type*
  • Current housing type*

  • Monthly Utility Expenses
    Heat:  $    *      
    Gas and electric: $   *   
    Water and sewer: $   *   
    Trash removal: $   *   
    Renter's or Homeowner's insurance: $   *   
       

  • Has the family moved in the last 24 months?*
  • Is the Parent/Guardian a member of the U.S. military on active duty?*

  • Additional Parent/Guardian Information

  • Would you like to add an additional parent or guardian?
    • Additional Parent/Guardian 
    • Additional Parent/Guardian's date of birth
       - -
    • Additional Parent/Guardian's preferred language
    • Is the Additional Parent/Guardian Hispanic, Latino, or of Spanish origin?  Hispanic, Latino, or of Spanish origin means a person of Cuban, Mexican, Puerto Rican, Central or South American, or other Spanish culture or origin, regardless of race.*
    • Select one or more races from the following five racial groups. Please check all boxes that apply to the Additional Parent/Guardian; check at least one box.*
    • Additional Parent/Guardian's employment status*
    • Format: (000) 000-0000.
    • Format: (000) 000-0000.
    • Format: (000) 000-0000.
    • Does the Additional Parent/Guardian live at the Primary Parent/Guardian's address?
    • Is the Additional Parent/Guardian a member of the U.S. military on active duty?*

  • Supporting Documents

  • You may upload the supporting documents here, drop them off at North Street School, or mail them to:

    Geneva CSD Head Start/UPK

    Attn: Head Start

    400 West North St.

    Geneva, NY 14456

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