New Sponsor Form 

Information in Red is required

Organization Name: 
Contact Name: 
Contact Email: 
Street Address: 
Street Address 2: 
City: 
State: 
Zip: 
Phone: 
Extension: 
Fax: 
Agency URL
Login Name: (no spaces)
Login Password: (no spaces)

Is your agency authorized to offer DCF courses?         Yes        No

Is your agency an accredited college or university?      Yes        No
Language in which you can provide training My target audience works with the following age groups
English
Spanish Infants
Creole Toddlers
French Preschool
Portuguese School-Age
Kanjobal Adults
Other   
Content/Core Knowledge Areas: Please check all areas in which you are qualified to train. 
Child Growth, Development & Learning  DCF Trainings/Certifications
Learning Environment 30-hour Family Child Care
Observation & Assessment 20-hour Center-Based
Adult Child Interaction/Guidance  10-hour Infant-Toddler
Program Structure/Curriculum 10-hour Young Child/Preschool
Health, Safety & Nutrition 10-hour Special Needs
Family, Parent & Community Involvement 10-hour School-Age
Diversity 5-hour Literacy
Professionalism 6-hour Train-the-Trainer
Administration/Management 3-Hr Fundamentals of Child Care
Abuse & Neglect Child Development Associate (CDA)
First Aid/CPR

10 Hr Behavioral
Developmentally Appropriate Activities Certifications
Environment Rating Scale 1.
Early Literacy 2.
Special Needs/Inclusion 3.
Other 4.
Audiences at your agency's training events:
Center-based child care practitioners Parents/Guardians
Family child care practitioners Pre-service teachers
School-age care practitioners Early intervention/special ed professionals
Center owners/directors Social workers
Resource teachers/Early learning coaches
Health services professionals

Other: