Central Kentucky Community Action                   Council Head Start

Serving: Hardin, LaRue, Marion, Meade, Nelson, Washington

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              Child Enrollment Application

To apply, please complete the following application.

Each application must have the following to be completely processed and considered for enrollment:

A. Verification of income of the family (Which includes any of the following):

           1. Proof of income for the last 12 months (pay stubs)

           2. Tax forms from the prior calendar year

           3. Proof of TANF or KTap

           4. Proof of Social Security Benefits

           5. Proof of Supplemental Security Income

           6. Child Support

           7. Unemployment

           8. Foster Care / Kinship Care

B. Proof of birth for children 3 or 4 years of age by August 1, of the enrollment year:

Hospital Documentation, Certified Birth Certificate, Passport Card, etc...

In order to process your child's application, it must have proof of income and proof of birth.  Information collected will be used to determine your child's eligibility.  Once you have completed the application, please submit it to the address at the top of the application.  Children are accepted throughout the school year until April as openings occur.  Families are notified by mail of their child's status.  If you cannot access the application on this web site or if you need assistance, please contact the central office at 270-692-2136. For online application, please click on the following link:


If you have any questions please contact Melissa Garrett. 


Phone: 270-795-4301     Ext. 406

2022 Enrollment Application