Child Development Associate Credential - Course Application

Thank you for expressing your interest in participating in the preparation course for obtaining the Child Development Associate Credential. Please complete this form and leave it at the receptionist desk.

How did you hear about this CDA course? _________________________________________________________________________

Name: ________________________________________________
Address:  ______________________________________________
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Phone:     (Home) ______________   (Other - specify) ________________
Best time to reach you:  ______________________________________

Are you 18 years old or older?:  q Yes    q No   
High School:      qCompleted  qIn progress
GED:                 qCompleted  qIn progress

Have you worked with children? q Yes q No      For how long? _______________________
In what capacity? ______________________________________________________________
Where? ______________________________________________________________________

 

Please mark the credential you would like to obtain: q Preschool CDA (Children ages 3 to 5)    q Infant/Toddler CDA (Children from birth to age 3)

Please mark the preferred language for the class: q English    q Spanish   q Bilingual (I can fluently speak, read and write in both languages)

Please write a paragraph about how obtaining a CDA credential will help you reach your professional development goals.  Why are you interested in obtaining a CDA credential? What do you hope to gain from having a CDA Credential? (Use an additional sheet if necessary)

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