MHCC Head Start 10100 NE Prescott St. Portland, OR 97220

Office Hours: 8 am. - 5 pm. Applications: 9 am. - 4 pm.
Saturdays only by appointments 8-11 am.
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Interest Form
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Phone: 503-491-6111
Fax: 503-491-6112
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Not in our boundaries? Check out Head Start near us
Head Start Locator Albina Head Start and Early Head Start Clackamas County Children's Commission Head Start, Early Head Start and Healthy Families Portland Public Schools Head Start Siletz Tribal Head Start Oregon Child Development Coalition

Interest Form

If you are interested in applying for one of our Early Head Start or Head Start programs, please fill out the interest form below and one of our staff will reach out to you to complete an application.
Additionally, you may download and fill out our pre-application form (English & Spanish) and attach it to the interest form below along with any proof of income (e.g. W2, paystubs, SSI award letter) you have. Further proof of income may be requested during the application process.

If you are unable to complete our pre-application or would prefer to do it over the phone, simply fill out the questionnaire below and we will be in touch. Thank you!

If you have any questions or concerns or simply would like to make an in-person appointment for an application please reach out to us at: 503-491-6111.

Sender's email *:
Parent/Guardian Name *:
Address *:
Preferred Language:
English Proficiency:
Child/Applicant Name *:
Date of Birth of Child/Applicant *:
Contact number *:
Phone number *:
May we text this number? standard text message rates may apply :
Best days/times to contact:
Message text. You can add additional family members here:
Is the family receiving TANF?:
Is the family receiving Supplemental Security Income?:
Is this a foster child?:
Attach Files:
Attach more files:
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How did you find out about us? *:
Please specify if there is an Agency Referral or Other *:
Security code *: