Application for Enrollment
In order for your child's application to be complete we need the following documentation returned with the application:

Birth Certificate
Immunization Record**
Proof of Income
Documentation of Child's Disability (if applicable)
Documentation of TANF Benefits (if applicable)


Physical Exam Completed by Physician or Provider (when child is accepted)
Dental Exam Completed by Dentist (when child is accepted)
Your child is required to have a completed physical and dental exam.  If you have any questions regarding this requirement, please see Head Start's Health Services Manager, Shelley Zastoupil, RN.

**The Nevada School Immunization Law requires that all children be up-to-date on their immunizations to attend school or a childcare program.  Listed below are the required immunizations:
Type of Vaccine
Age
                          IPV
2mo     4mo     6-18mo                  4-6yrs
                          DTP, DT (Dta, 4th & 5th dose only)
2mo     4mo     6mo    15-18mo     4-6yrs
                          MMR
                                   12-15mo     4-6yrs
                         Hib
2mo     4mo     6mo    12-15mo
                         Hep A
                                    24 mo   30 mo
                         Hep B
Birth     1-4mo  6-18 mo
                         Varicella
                                   12-18mo
If your child does not have an Immunization Record or has not received all required immunizations, call your doctor, local clinic, or Head Start's Health Services Manager as soon as possible.


Please click on a link below for the correct application






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