Applications

On My Way Pre-K

New Applicant

Please complete the online application if you are a new applicant. If there are issues, you are welcome to schedule a phone appointment.

Returning Applicant

The following forms need to be downloaded, filled out, and emailed or mailed to CCDF staff at Geminus.

Form Descriptions:

• Name Attestation – Form SF 57096 required to complete if applicant goes by more than one name.
• Application – Form SF 56895 to complete if applying for the On My Way Pre-Kindergarten Program.
• Earnings Information (Español) – Form to complete to verify earned income.
• Parent Agreement (Español) –  Form to complete agreeing to participate in the requirements of On My Way Pre-K.
• Provider Information (Español) – Form SF 56897 to be completed by the On My Way Pre-K applicant’s chosen provider.

Give Your Child a Head Start

Nothing is more important to long-term success than early education – and Geminus Head Start is your family’s partner preparing your child to thrive in school. We offer no cost programs designed to help prepare young learners for children birth to five years from qualifying families in Lake and Porter counties.

Our highly-qualified classroom teachers provide full-day and half-day programs at locations throughout northwest Indiana, serving more than 2,000 families each year.

Priority enrollment given to children receiving SNAP, SSI or TANF, and those in the foster care or experiencing housing instability.

Ready to get started? Complete the form below and one of our staff will contact you shortly to schedule an appointment to begin the application process.

This form is NOT an application for admission to the Head Start program. You must complete an intake appointment with one of our staff in order to be considered. For faster service, please contact one of our locations directly to schedule an appointment.

Enrollment Requirements:

• Copy of child’s birth certificate
• Proof of income for the last 12 months
  • or SNAP, SSI, TANF benefits letter if applicable
  • or foster care/guardianship paperwork if applicable
• State issued photo identification
• Physical with immunization records

School readiness begins with health!

Our program follows Indiana child care licensing and Head Start Performance Standard regulations that require all enrolled children to complete a school physical exam each year of enrollment and a dental exam every 6 months. Please use the link below to download physical and dental exam forms to take to your medical providers. If you need help establishing a medical provider, our Program Assistant can help you find the best provider to suit your needs.