Family Application

Family ApplicationApplicación de Familia


NCS Fillable PDF Application – Download and email completed form to

Solicitud que puede entregar por correo electrónico en español. Descarga la solicitud aquí. Manda la solicitud llenada al siguiente correo:

Instructions for completing application

Children enrolled in the Northcoast Children’s Services programs are between the ages of birth to 5 years old.  Children who are eligible for kindergarten are not eligible for Head Start, Early Head Start or State Preschool.  Children with special needs and their families are encouraged to apply, as well as foster children.

Siblings of enrolled children are not automatically enrolled in the program.  Parents must apply separately to Head Start and Early Head Start or State Programs for each child they want considered for enrollment.  Applications are also accepted for pregnant women.


Applications are considered confidential.  Applications include confidential financial, health and special needs information and processed applications are kept in a locked file room.

Applications can be picked up at any Northcoast Children’s Services program site, at the Main Office, mailed to you, or you can print one out online.

Application information needs to be filled out completely and returned to Northcoast Children’s Services with written proof of income and immunization record for the child.  Applications for pregnant mothers need only to be returned with written proof of income.  Call or e-mail our Enrollment Technicians if you have questions regarding your applications.

Applications are usually received at the main office in Arcata to the attention of the Enrollment Coordinator.

If the application is incomplete (no shot record, income verification or parent signature), we will give you a call.   As a last resort, we will return the application with a letter to the parent or guardian stating the information needed.  A self-addressed, stamped envelope is included so the parent can mail back the completed application.