Program Application - Fall 2019
If you have questions or need additional information, please call CDL at 504-840-9786 or email apply@cdl.org.
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Email *
Personal Information
Name: (first, middle initial, last) *
Last 4 SSN: *
Home Address: (street, city, zip) *
Cell Phone: *
Additional Contact Number: *
Do you have access to a computer outside of work? *
Employment Information
Employer: *
Address: *
Phone: *
Start Date at Center: *
MM
/
DD
/
YYYY
Employment Status: *
Position: *
Ages Taught: (Check all that apply.) *
Required
Education
Do you have a high school diploma or GED? *
Do you have a college degree? *
If yes, degree received:
Area of study:
Early Childhood Experience
How long have you been employed in the early childhood field? *
Which age groups have you worked with? (Check all that apply.) *
Required
Have you started the CDA certification process, applied for a CDA, or received a CDA credential in the past? *
If yes, please explain?
Do you already have clock hours that you have obtained for the purposes of getting a CDA? *
If yes, approximately how many hours do you have?
Assurances and Signature
I certify that my answers are accurate and complete to the best of my knowledge and that I understand that false or misleading information on my application or within the required documentation may result in the rejection of my application. *
Required
Incomplete applications will not be accepted. Deadline for applications is July 12, 2019.
A copy of your responses will be emailed to the address you provided.
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