STAFF FORM-Census 2023-24

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STAFF FORM-Census 2023-24

To be completed by each person working at the ECI, including volunteers. Only ONE form per person. Please answer all questions relevant to you.

The survey administrators shall keep completely confidential the names of respondents, all information or opinions collected, and any information about respondents learned incidentally. Individual responses or data potentially traceable to an individual will not be shared for any purpose. Survey administrators shall exercise reasonable caution to prevent access by others to survey data in their possession.

1. Name of Staff: *

2. Staff's TRN: *

Enter correct format including dash (123-456-789)

3. ECI Name: *

4. ECI ID: *

If you do not have an ECI ID, please enter 000000.

5. ECI Address: *

6. Region *

7. Parish *

8. Zone: *

9. Cluster: *

10. Sex: *

11. Age as at Last Birthday: *

18-25 years Old

26-35 years old

36-45 years old

46-55 years old

56-65 years old

65 years and older

12. Cellphone #:

Please enter a valid format. (876-123-4567)

13. Email: *

14. Main Job title *

Principal

Vice Principal

Teacher/Early Childhood Practitioner

ECI Operator / Owner

Caregiver

Administrative Staff ( E.g. Secretaries , Bursars, Receptionist , etc.)

Nurse/Health Care Worker

Guidance Counseller/Psychologist

Volunteer

IT Personnel

Auxiliary Staff ( E.g. Janitors and Groundsmen )

Cooks/ Canteen or Tuck Shop Attendees / Cashiers and Servers

Security Staff

Speech Therapist/Special Needs Specialist

Driver

Other:

15. Do you perform any additional role at the ECI? *

Yes

15a. Please Indicate the additional role performed at ECI:

Principal

Vice Principal

Teacher/Early Childhood Practitioner

ECI Operator

Caregiver

Administrative Staff ( E.g. Secretaries , Bursars, Receptionist , etc.)

Nurse/ Health Care Worker

Guidance Counsellor/Psychologist

Volunteer

IT Personnel

Auxiliary Staff ( E.g. Janitors , Groundsman )

Cooks/ Canteen or Tuck Shop Attendees / Cashiers and Servers

Security Staff

Speech Therapist / Special Need Specialist

Driver

Not Applicable

Other:

Clear selection

16. Total number of years of service at current ECI: *

Less than 1 year

1 – 2 years

2 – 5 years

5 or more years

Clear form

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This form was created inside of The Early Childhood Commission. Report Abuse

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