FCC CDA Assessment Fee Scholarship Application 10

National Child Development Associate (CDA) Scholarship Application

CDA Scholarship Programs

Scholarships are available for early childhood professionals earning their National Child Development Associate Credential (CDA) . CDA Professional Development Scholarship (up to $300 for training support) . CDA Advisor/Observation Scholarship (up to $300 for a qualified advisor) . CDA Direct Assessment Fee Scholarship ($325)

Depending on eligibility requirements, you may be able to apply for one or more of these scholarships. Contact Holly Meuers with questions about the application: [email protected], 651-290-9704 ext. 109.

Eligibility

Eligibility requirements vary depending on the scholarship(s) for which you are applying. All applicants must be employed as a licensed family child care or center provider in Minnesota and must join the Center for Professional Development Registry at http://mncpd.mncpd.org/registryapp/Default.aspx. Requirements for the CDA Professional Development Scholarship (for training support) . Have completed a minimum of 30 hours of training towards your CDA.. . Take courses through your local Child Care Aware of Minnesota agency or Eager-to-Learn online learning program. Requirements for the CDA Advisor/Observation Scholarship . Use a registered CDA Advisor at: http://mncpd.mncpd.org.

Requirements for the CDA Direct Assessment Application Fee . Have met the Council of Professional Recognition’s requirements for the direct assessment fee application. Directions Checklist

Did you include the following?

 Completed CDA scholarship application  Copy of family child care or center child care license  Proof of income (copy of most recent schedule C if family child care or copy of most recent paystub if center employee)  Completed learning plan if applying for training scholarship  Completed Council for Professional Recognition direct assessment fee application if applying for assessment fee scholarship

Please return your completed original application and documents to: Child Care Aware of Minnesota Attn: Holly Meuers; 380 E Lafayette Road, Suite 103; Saint Paul, MN 55107 Applicant Information

First Name Middle Initial Last Name

Address City County State Zip Code

Home Phone ( ) Alternative Phone Number ( ) E-mail Address

MN Center for Professional Development Registry ID number ______

What ethnicity do you consider yourself? (For statistical purposes only) Black/African American White/ European American Hispanic/Latino/Latina American Indian or Alaska Native Asian/Pacific Islander Biracial/Multicultural Other ______

Scholarship Options

Scholarship(s) for which you are applying (check all that apply): □ CDA Renewal □ CDA Professional Development Scholarship (training) □ CDA Observation Scholarship □ CDA Assessment Fee

Program Information

□ Licensed family child care provider With which age group(s) do you work? (Check all that apply) □ Licensed child care center employee □ Infant □ Toddlers □ Preschool

How many hours per week do you work directly How long have you worked at your current location? with children? ___per week ___years ___ months

Does your program care for children on Child Care Assistance? County of employment ______□ Yes □ No

If no, are you willing to do so? □ Yes □ No

Education

□ High school diploma/ □ Two-year degree □ Four-year degree □ Graduate degree GED or alternative equivalent

MyStatement signature below and Signatureindicates that of I agree Applicant to the following:

. All information I have provided on this application is true and correct. . Child Care Aware of Minnesota may share my name and the fact that I received a CDA scholarship with others. ______Signature of applicant Date