early head start & head start information request form:

Coastal Community Action, Inc. Family and Children’s Program Head Start and Early Head Start works with eligible families who have children ages 1 to 5 years old at no cost. Early Head Start and Head Start programs enhance children's physical, social, emotional, and intellectual development through either center-based or home-based program options. The program supports parents' efforts to fulfill their parental roles; and help parents move toward self-sufficiency. We are actively looking for eligible children to receive our high quality services.

(* Indicates required fields)

Parent/Guardian Name*:
Children*:
Age Range of Children to Enroll*:
Address*:
City*:
State*:
Zip Code*:
 
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A common thread through all of our services, be they Family Services, Senior Services, or Housing Services, is that we help change lives by providing needed resources and support. Coastal Community Action, Inc. provides needed services to thousands of residents in our region annually.