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CEO Early Head Start/Head Start Application Signature
Home / CEO Early Head Start/Head Start Application Signature

  • Date Format: MM slash DD slash YYYY
  • I verify that all information submitted electronically for my child’s application for Early Head Start/Head Start is accurate. I understand that any misrepresentation of critical information could result in the denial of services for my child and family.
  • Date Format: MM slash DD slash YYYY
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