Center for Early Childhood Professional Development

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CECPD Home Requirements for becoming an Educator Download Application Educator's Training Calendar Forms and Information Curriculum Return CDA Advisor Training Online Course Reg Frm (All but ELCCT) Online ELCCT Reg Frm Specialized Training Director's Training Calender Caregiver's Training Calendar Tier II Training Calendar CDA Advisor List CCP Field Counselor List CDA/CCP Visit Expectations Webinar

Child Care Careers Course Registration

Choose one: Caregiver Course
Director Course

30-Day Notice
Registration must be in our office
30 days prior to start date! Please do not fax.

NOTE: Incomplete or late registrations will be returned.
Course Title:
Start Date: Material Return Date: # of Partic. Expected:

NOTE: If there is a change in COURSE DATES or INSTRUCTOR, PLEASE contact our office IMMEDIATELY!

Mail Materials To: Educator Training Site Educator will pick up materials

DO NOT send: Educator Manual Resource Kit

(UPS WILL NOT DELIVER TO A P.O. BOX)
Educator's Name:
Address:
City: State: Zip: Phone:
Training Site:
Address:
City: State: Zip: Phone:

Payment Options (Check One): I am eligible and wish to receive payment from CECPD.
I am receiving payment from another source.
I am training this course on a voluntary basis.

Notes:

OFFICE USE ONLY:
CONF
PIF #
RES #
TO REG
APP CODE
PW/INV

CHECK HERE if the Educator's permanent address (above) has changed.

Session 1	Date	M	Tu	W	Th	F	Sa	Su	Time
Session 2	Date	M	Tu	W	Th	F	Sa	Su	Time
Session 3	Date	M	Tu	W	Th	F	Sa	Su	Time
Session 4	Date	M	Tu	W	Th	F	Sa	Su	Time
Session 5	Date	M	Tu	W	Th	F	Sa	Su	Time
Session 6	Date	M	Tu	W	Th	F	Sa	Su	Time
Session 7	Date	M	Tu	W	Th	F	Sa	Su	Time
Session 8	Date	M	Tu	W	Th	F	Sa	Su	Time
Session 9	Date	M	Tu	W	Th	F	Sa	Su	Time
Session 10	Date	M	Tu	W	Th	F	Sa	Su	Time