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About Us
Vision & Mission
Strategic Roadmap
Staff
Board of Directors
Careers
Support
Give Now
Corporate & Foundation Giving
In-kind Donation
Shop & Support
Annual Report
Contact
Social Media Policy
Professional Development
PennAEYC Membership
Conferences
UnConference
Virtual UnConference: Caring in a “New Normal”
Courses
Request for Professional Services
Catalog
Message from Me
Coaching & Mentoring
CDA Credential
Advocacy
Take Action
Public Policy Agenda
Get Public Policy Updates
Early Learning PA
ECE Advocacy Fellowship
Call It Child Care
Resources
Community Resources
Hub & Family Center
Find Child Care
Community Learning Hubs
Forum
Parenting Resources
Playful Pittsburgh Collaborative
Anti-Racism Tools
COVID-19
Kindergarten Transition
Community Engagement Request
News & Events
News
Events
Month of the Young Child
Subscribe to our Enewsletters
Previous Issues
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Apprenticeship Interest Form
Thank you for showing interest in our Apprenticeship Program. After completing the form, a member of our staff will contact you to determine your eligibility.
Are you completing this form on behalf of someone else?
*
I am completing this form on behalf of someone else.
I am completing this form for myself.
What is your position?
*
Owner
Director
Lead Teacher
Assistant Teacher
Aide
Other
Program Information
*Please note that the Apprenticeship Program is employer driven and requires the apprentice to have access to an onsite coach with whom they are employed with.
Program Name
*
Program Address
*
Program City
*
Program State
*
Program Zip Code
*
Program County
*
Program Phone
*
STAR Level
*
No STAR Level
STAR Level 1
STAR Level 2
STAR Level 3
STAR Level 4
Age Group(s) You Serve
*
Infant
Toddler
Pre-k
Kindergarten
School Age
Adults
None of the Above
Director Name
*
Director Email
*
Director Phone
*
Choose all that apply:
Pre-K Counts
Head Start
Early Head Start
NAEYC Accreditation
Family Child Care
Coach Name
*
Elizabeth Foreman
Holly Cessna
Jillian Miller
Kathy Wolfe
Katie Streiff
Lindsey Perry
Nicole Paulovich
Perrinda Sandiford
Shawna Mohler
Jasmine Mercedes
Andrea Gardner
I don't have a coach.
Apprentice Applicant Information
First Name
*
Last Name
*
Email
*
Phone
*
Race and Ethnicity
*
Native American/Indigenous/Alaskan Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
Hispanic or Latino
Middle Eastern or North African
Other
Prefer not to say
Gender
*
Female
Gender Noncomforming/Genderqueer
Male
Something Else
TransFemale/TransWoman
TransMale/TransMan
Prefer not to say
Do you have a high school diploma or GED?
*
Yes
No
Address Line 1
*
Address Line 2
*
City
*
County
*
Zip
*
State/Province
*
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
American Samoa
Federated States of Micronesia
Guam
Marshall Islands
Northern Mariana Islands
Palau
Puerto Rico
U.S. Minor Outlying Islands
Virgin Islands
Armed Forces Americas
Armed Forces Europe, the Middle East, an
Armed Forces Pacific
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Nova Scotia
Northwest Territories
Nunavut Territory
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon Territory
This form is intended for individuals who live in Pennsylvania. Do you live in the state of Pennsylvania?
*
Yes
No
Pennsylvania PD Registry Number
*
Apprentice Education Information
Have you previously obtained college credits?
*
Yes
No
Are you currently working in early education?
*
Yes
No
Number of years working in the early childhood field?
*
Do you have access to reliable internet/Wi-Fi and an electronic device?
*
Yes
No
What is your highest level of educational attainment?
*
None
High School
Some College Credit
Associate's Degree
Bachelor's Degree
Master's Degree
Ph.D.
Other
Would technology be a barrier for completing coursework or attending online classes?
*
Use this space to tell us more about any questions or thoughts you may have.
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