CDA Interest Form

You are inquiring about Trying Together’s CDA program. We are now actively enrolling for fall cohorts (all hybrid, all beginning 09/14 and running through May 2027).

Applicant Information

Are you completing this form on behalf of someone else? If so, please fill in the applicant's information below. *

First Name *

Last Name *

Phone *

Email *

Address Line 1 *

Address Line 2

City *

State/Province *

County *

Zip *

Race/Ethnicity

Gender

PA Registry ID number

Program Information

Child Care Program Name *

Child Care Program Zip Code *

Child Care Program County

Child Care Program Phone

Child Care Program STAR Level

What is your position?

CDA Information

Which type of CDA credential are you seeking? Please note that eligibility requirements are much higher for Birth - 5. If selected, a staff member will contact you to confirm eligibility.

What is your highest level of educational attainment? (Note: If you have a bachelor's degree in Early Childhood Education, you do not need to obtain a CDA.) *

Number of years working in the early childhood field

Are you currently working in an Early Head Start classroom? *

For this course, you will need a laptop computer with a working camera. A tablet/ipad or cell phone will not be compatible with our online learning platform. Will you need to borrow a laptop with a camera? *

How did you hear about this?

Flyer/Brochure

Social Media

Trying Together Newsletter

Trying Together Staff

Trying Together Website

Online Search

Friend/Colleague

Another Organization

Other

Data Privacy & Consent

Email

SMS/MMS