Overview of ITERS-3 -Registration form

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ITERS-3 June 21-22 6-8:30 PM
Great opportunity to learn all about ITERS-3. This training is designed to address best practices from a teacher's perspective, for teachers working with children ages 0-3. Training takes place over 2 sessions June 21-22, 6-8:30 PM. Please attend both to receive the certificate!

I am filling out this form for my self or on behalf of some one with their permission. The person attending, acknowledges the dates and times of this training. *

Yes

Participant's Full Name *

Email address( the one used for PDIS account) *

Personal Cell Phone Number *

Job Title (Please check all that apply) *

Administrator

Teacher

Childcare Provider

Other:

Required

What ages do you work with? *

Infant( 0-12m )

Toddler ( Ages 12m -24 m)

Toddler (Ages 2 yr -3yr)

Preschool ( 3yr-4 yr)

Prek ( 4-5)

Other:

Required

Center / Agency Name *

Center / Agency Phone *

Center / Agency Address: Street *

Director's Name ( If applicable) *

Does your program have families from

CCAP

Low income

Families experiencing homelessness

Refugee population

Minority groups

Other marginalized and disadvantaged groups

How did you hear about this training?

All registrations are final. No credits or refunds will be issued. I have verified that the training dates works for me. I know that the payment is non-refundable. *

Yes

How would you like to pay for this training *

Zelle: Sobia 303-807-2525

Venmo: My ID is @coloradochildcareconsulting ( add $2 charge/person)

Use Credit card at PayPal, my ID is: https://paypal.me/LETSDOPPA?locale.x=en_US ( add extra $2/person)

Please put your full name and training name in the payment notes. for example "Jane smith, June ITERS-3"

You are not registered until this form and payment is received. Please contact me: Sobia@coloradochildcareconsulting.com with any questions. *

Yes, I have contacted Sobia, to confirm availability before submitting this form with payment information.

Required

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