CDA Interest Form

You are inquiring about Trying Together's CDA Prep program. After completing the form, a member of our staff will contact you to discuss your next steps. PLEASE NOTE: The Fall 2024 CDA cohort is currently full. Individuals who fill out the CDA Credential Program Interest Form will be considered for the Spring 2025 CDA Cohort, which begins in February. Trying Together will begin enrolling participants in January 2025.

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 *

County *

State/Province *

Zip *

Race/Ethnicity

Gender

Pennsylvania PD 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?

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

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CDA Interest Form

Applicant Information

Program Information

CDA Information