Creative Trainers and Consultants Director's Training Enrollment Application

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West Houston, Texas
Southbriar Community Association

Select from one of the classes below.
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INSTRUCTIONS

YOU WILL NEED TO FAX THE FOLLOWING INFORMATION TO (281) 679-1032

• Valid Driver’s License showing you are at least 21 years of age;

• Copy of High School Diploma, GED and/or college transcript;


YOU WILL ALSO NEED THE FOLLOWING EXPERIENCE

• Two years experience working in a licensed child care center or registered family or group home.


YOU WILL ALSO NEED TO ARRANGE FOR PAYMENT - TOTAL PAYMENT IS $500

Deposit of non-refundable fee of $100 to reserve space in a scheduled class.

We accept checks, money orders, or cash.


Balance of $400 is due and payable by first scheduled class.

We accept checks, money orders, or cash.


 Mail Deposit of $100.00 to:

 CREATIVE TRAINERS AND CONSULTANTS

11927 Waldemar Drive

Houston, Texas 77077-4954

 

ATTENTION:  Judy Carnahan-Webb


Contact Judy at:

(281) 493-4787       

Email:  judy@judycarnahanwebb.com

 


PERSONAL INFORMATION
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Which phone do you prefer us to contact you at?
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What Type of Program are you currently working in? *
 

A. CURRENT EMPLOYMENT INFORMATION

B. PAST EXPERIENCE WORKING WITH CHILDREN
PLEASE LIST MOST RECENT EXPERIENCE FIRST.

C. EDUCATION

D. PERSONAL REFERENCES (List two)

E. STATEMENT OF UNDERSTANDING AND ENROLLMENT AGREEMENT

As a participant enrolled in the CHILD DEVELOPMENT DIRECTOR CREDENTIAL PROGRAM conducted by

CREATIVE TRAINERS AND CONSULTANTS, I will:

1. Meet eligibility criteria before course completion;

2. Attend and actively participate in all required components of the Program;

3. Make up any work missed with approved excused absences;

4. Complete coursework within a 6-month period;

5. Agree to and follow all the policies and procedures of the Program;

6. Notify Creative Trainers and Consultants of any changes in name, address or telephone number;

7. Notify Creative Trainers and Consultants when you have received the Director’s/Administrator’s Seal from the Texas Department of Family and Protective Services, assigning you as the Director of a Licensed Child Care Center or Registered Family or Group Home; 

8. Pay the required fees according to the prescribed procedures of the Program before the credential is awarded;

9. Notwithstanding any other agreements, hold harmless and indemnify Creative Trainers and Consultants against any legal liability in respect to bodily injury, death and/or property damage while participating in the Program.


F . STATEMENT OF CREATIVE TRAINERS AND CONSULTANTS COMMITMENT:

CREATIVE TRAINERS AND CONSULTANTS will:

1. Offer professional development and refresher opportunities year round;

2. Not discriminate on the basis of sex, race, color, religion, national origin or age;

3. Provide a current and quality PROGRAM in compliance with Texas Department of Family and Protective Regulatory Services Minimum Standards for licensed child care centers and child care homes;

4. Communicate all policy and procedural changes in writing and/or orally, as appropriate;

5. Maintain confidential participant’s records on Access Data Base (accessible only to specified authorized individuals and Licensing);

6. Issue a Certificate of Credential upon the participant’s successful completion of all Program requirements;

7. Issue a Renewal Certificate of Credential upon the participant’s successful completion of all Program requirements;

8. Notify the Texas Department of Protective and Regulatory Services of any participant’s suspension or revocation of Credential.


G. STATEMENT OF DISCLOSURE

I certify that:

1. I have never been convicted of a felony offense or misdemeanor classified as:

• an offense against the person or family;

• a public indecency; or

• a felony violation of any law intended to control the possession of any substance included as controlled substance in the Texas Controlled Substance Act.

2. I have completed all information required on this application form;

3. I have provided the following as evidence:

o Valid Driver’s License verifying date of birth;

o Copy of High School Diploma, GED and/or college transcript;

o Resume showing at least two years experience in a licensed childcare center or registered family or group home with current contact information.

4. I have read and understand the STATEMENT OF UNDERSTANDING AND ENROLLMENT AGREEMENT;

5. I have read and agree with the above requirements and certify that I have provided accurate and factual information.

6. On the first day of the class, I will be required to sign a letter acknowledging that all the information on this form is accurate.

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