QRIS-Indicator Review Training-Registration form

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Indicator Review June 28- 5:30 to 8:30 PM
For administrators and directors seeking an overview of Colorado Shines L3-5 indicators and the policies and procedures required to earn points.

Email *

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

Yes

Participant's Full Name *

Email address( 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

CCCAP

Families experiencing homelessness

Low income

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 date 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)

PayPal: My PayPal 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 Indicator Training.”

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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