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Opening Doors for Children & Families

Head Start Registration

ABC Head Start is an early learning and family support program for vulnerable or families living on a low-income. Children with significant developmental delays may be eligible for Head Start if they are 2 years 8 months old at the beginning of the program year (September). Children without significant delays must be 3 years 8 months old at the beginning of the program year. Transportation may be available for your child within your community. The following questions let us know if your family can access Head Start services and which site is nearest you. If your family is not eligible for Head Start, we can help you find other programs for you and your family.

Documents

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)

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

Required Documents
Files must be less than 100 MB.
Allowed file types: txt pdf png jpg jpeg doc docx.
Referrals

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

If this application has been filled out on behalf of a family they MUST be aware of the referral.

403-555-1234 x143
403-555-1234 x143
Interview Date
E.g., 09/21/2019
Child Information
Daycare or Dayhome Provider
Childcare Address
403-555-1234 x143
$
Total before tax income for ALL income earners living in the home.
Parent Information
(if different from application)
Parent/Guardian 1
Parent/Guardian 1 Home Address
403-555-1234 x143
403-555-1234 x143
If E-Mail address is provided, you consent to receive electronic E-Mail’s from ABC Head Start Society
403-555-1234 x143
Alternate Contact Information
We will contact this person if we’re unable to contact you concerning this registration form. Please notify this person they are listed.
403-555-1234 x143
Alternate Contact Address
Check all that apply.
Declaration by Parent or Legal Guardian

The information provided in this document is true, correct and complete. I have, in either Agency Application or ABC Head Start Registration Form, 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 ABC Head Start should the above information change.