Application for Services



Family Service Workers complete Head Start applications on an ongoing basis. The State program EESD9600 Application for Services are completed at the same time during high enrollment periods or after selected for enrollment. During the application process, parents will be informed of their eligibility status and their child’s name will be placed on the COPA waiting list.  Parents will be provided information about and other child care programs in the area if they do not meet the Head Start eligibility requirements. 

Regulations & Policy

HS Performance Standard 1302.12 & State Title 5 Section 18082

Prior to initial enrollment and at the time of roll-over/recertification, programs must certify each family's/child's eligibility. To learn about the regulations watch the following lessons and review the process:

  • Head Start: HS ERSEA Course/Lesson 1: Eligibility

  • State: Governance & Administration Course/Lessons 1 - 6

Application & Enrollment Processes

These processes are intended to help guide staff through the application and enrollment process based upon the program model children are served in.

Learn How to Apply

To assist families enrolling in one of our programs resources are available online.

Click on the link below to access waiting list information, enrollment checklists/ packets and Learn How to Apply videos. 

Completing the Applications

Applications are completed with the parent/guardian through an interview process.

Family Service Workers complete Head Start applications in COPA on an ongoing basis. State program applications are completed in CenterTrack during high enrollment periods or after selected for enrollment. 

Supporting Forms & Tools

NOTE: Required forms are included in How to Apply packets located at The Income & Family Size worksheet  must be included with each HS application. The State Income Calculation Worksheet or CenterTrack's income worksheet must be included with each State application. The other tools are resources. The forms listed below are used as applicable to the family's case. 

HS Application Process

All data regarding income, date of birth, immunization status and any special circumstances must be verified by the staff completing the application, health staff and management staff.

  • Family Service Worker (FSW) or designee assists parents with documentation and completes HS application within COPA

  • Child Information Form. Place original on top of application. For concerns send copy to:

    • Education - Chris Lemings

    • Health & Nutrition - Nurse

  • Health staff approves immunization records

    • Preschool: Stop sign is used if not complete

    • Infant/Toddler: Stop sign is always used

  • If applicable, disability staff verifies current IEP/IFSP

  • FSW organizes application documents for manager to review

  • Using the monitoring tool, manager reviews and approves

    • Extended-Day: Family Eligibility Specialist approves - Jessica

    • Full-Day: Master Teacher approves

  • Manager or designee moves the application to the COPA Eligible/Accepted List indicating the following program model:

    • Extended Day = COPA Full Day

    • Full Day = COPA Full Working Day

    • Home Based = Home Based


  • FSW maintains the application and supporting documentation within the Application Waiting List binder

State Program Application Process

Confidential Application for Child Development Services and Certification of Eligibility (EESD9600), must be completed and signed by the parent and an agency representative within 30 days prior to child entering care. 

Exception: Part-day state preschool in extended day classrooms have 120 calendar days prior to the first day of the beginning of the new preschool year to certify eligibility and enroll families into their program. 

High-enrollment periods OR at the time of enrollment: 

  • Family Service Worker (FSW) or designee assists parents with documentation, and completes the eligibility and child portion of form EESD9600 within the CenterTrack database

  • FSW organizes application documents for manager to review based on the order of the Family Data File Checklist

  • Family Eligibility Specialist (FES) analyzes and completes the need section of form EESD9600. If any family member is enrolled in anther state program, such as the Alternative Payment program, the FES will complete all portions for all state programs for which the family is enrolled in

  • FES reviews and approves EESD9600

  • FES or designee must issue a Notice of Action (NOA) to approve or deny services. The NOA must be mailed or delivered to the parent within 30 calendar days from the date the EESD9600 was signed by the parent

  • Family data file is compiled once child is enrolled

    • Extended-day sites: Maintained at the site

    • Full-day sites: Maintained at the Celeste office


  • Family Service Worker (FSW) or designee assists parents with documentation, and completes the Eligibility Determination Waiting List Application form, instead of form EESD9600

  • FSW maintains Eligibility Determination Waiting List Application form, along with supporting documentation, which is placed with the HS Application in the Waiting List & Enrollment Binder

  • Once a child is selected for enrollment from the waiting list, state documents are updated and the EESD9600 is completed

Application Binders

Waiting List Binder

Monthly waiting list report, vacancy waiting list report and approved applications are maintained in the Waiting List binder until a child is selected for enrollment. 

Incomplete, Ineligible or Declined Application Binder

Applications that are incomplete, ineligible or have been declined enrollment are maintained in a seperate binder.



A Grantee monitoring review will be held every program year. In addition, self-monitoring must be documented and occur as follows:

  • ERSEA: Within first 45 days

  • FSPA Assessment: Within 60 days

  • FSPA Goals: Within 70 days

  • Case Conferencing: Quarterly

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