Spring 2012 Participant Profile & Confidential Survey Form
Two forms are required this fall for participation in our grant which includes the book loan program and tuition reimbursement
#1 Profile form PLEASE PRINT FORM BACK TO BACK ON ONE PIECE OF PAPER - requires signed Employer verification - form can not be faxed, original signatures required
#2 Confidential survey (students that participated in Fall only need to do the short form which is available in Muir 157)
If you plan on borrowing CLDDV books, you must present both forms fully completed with a copy of your Fall Schedule showing enrollment in the course.
Daytime hours for the book loan program are
M-F 9:00 AM to 1:00 P.M January 9 - January 19th, closed Monday Jan. 16th for MLK.
Evening hours for the book loan program will be 5-7 PM Monday - Thursday the first two weeks of school.
Open the form using the above link. Click on the icon in the upper right corner that says "highlight fields". This will help you complete the form since all the fields needed to be filled in will be highlighted in light blue.
Fill the form out from your keyboard. Save the form to your computer. Print the form on 1 sheet of paper, back-to-back.
Have your employer sign the form and complete the employer information. Please, no abbrevations for the employer's name. CCCDS should be spelled out "Central California Child Development Services". SCOE should be listed as Stanislaus County Office of Education.
Mail or return to Muir Hall 157 no later than date in upper right hand corner of the form.
Remember, when printing out this form,
please print it on 1 sheet of paper, back-to-back
.
Original signatures required so form cannot be faxed.
Do you work in a licensed program with children ages 0-5, kindergarten, before/after school or off-track care? Are you a licensed day care provider?
Do you provide child care in an adult education setting, at a private school site, in a facility where parents are on-site or a co-op?
All of the above qualify you to become a Participant in our Child Development Training Consortium grant.
If you are not receiving financial aid or your employer or another third party does not pay for your tuition, you can apply for tuition reimbursement at the end of the semester for all classes numbered 50 and above (no work experience or physical education) that you receive a grade of C or better in. The reimbursement is based on all books being returned by Finals week. Deadline for requesting reimbursement is thirty days following the end of the semester
We have purchased textbooks for loan for most of the Child Development core classes and some of our elective classes. There are some textbooks available for general education classes also. Books are loaned on a first come, first served basis - your Participant Profile must be completed in full before textbooks can be borrowed.
