Get Head Start/early Head Start Eligibility Verification 2013-2025

The Head Start/Early Head Start Eligibility Verification form is essential for determining eligibility for these vital programs. This guide provides clear, step-by-step instructions to help you successfully complete the form online, ensuring all necessary information is accurately provided.

Follow the steps to fill out the Head Start/Early Head Start Eligibility Verification form online

1. Press the ‘Get Form’ button to access the Head Start/Early Head Start Eligibility Verification form and open it in your preferred editor.
2. Begin by entering the child’s name in the designated field.
3. Indicate the child's gender by selecting either 'Male' or 'Female'.
4. Enter the PEIMS number in the appropriate section.
5. If applicable, provide the mother's name for Early Head Start programs.
6. Fill in the child's date of birth in the required format.
7. Select the program type by choosing either 'Head Start' or 'Early Head Start' and indicate the year of the program, if applicable.
8. Specify the campus in which the program will take place.
9. Mark the status by selecting either 'Applied' or 'Waiting List' and include the corresponding dates.
10. Indicate whether the child has a diagnosed disability by checking 'Yes' or 'No'.
11. If applicable, confirm if the disability documentation is on file.
12. Select the type of documentation used to determine eligibility by marking the relevant options.
13. Record the total income as required, including documentation details for income verification.
14. If applicable, indicate any categorical eligibility circumstances and mark the correct options.
15. Enter the date of eligibility verification.
16. Add the family size in the specified section.
17. Final decisions regarding eligibility should be marked, along with any specific documents received.
18. Sign and print the staff name at the end of the document.

Complete your Head Start/Early Head Start Eligibility Verification form online today to ensure timely processing.