JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Dogwood Health Trust Early Childhood Education Application
This application is for the Dogwood Health Trust Early Childhood Education Grant. By filling out this application, you are agreeing to the following items:
Completing a McDowell Technical Community College Admissions Application.
Providing an official high school diploma (or equivalent). *Note: this must be translated prior to be provided to MTCC's Registrar's Office.
You are at least 18 years of age.
Maintaining a GPA of 2.0 at MTCC while you are receiving these funds.
Completing a FAFSA, if you are a citizen or an eligible non-citizen (generally, you are an eligible non-citizen if you are (1) a permanent US resident with a Permanent Resident Card (I-551), (2) a conditional permanent resident card (I-551C), (3) the holder of an Arrival-Departure Record (I-94) from the Department of Homeland Security showing any of the following designations: "refugee", "asylum granted", "parolee" (I-94) confirms that you were paroled for a minimum of one year and status has not expired), T-Visa holder, or "Cuban-Haitian Entrant" , (4) the holder of a valid certification or eligibility letter from the Department of Health and Human Services showing a designation of "Victim of human trafficking" OR
Providing documentation showing you are not eligible to submit a FAFSA (i.e. DACA)
Being aware a criminal background check, including fingerprinting, through the
Department of Health and Human Services
, is required to be employed in a North Carolina childcare facility.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Please provide your legal first and last name.
*
Your answer
Please list your email.
*
Your answer
Please provide the best phone number to reach you.
*
Your answer
What semester are you hoping to begin courses?
*
Fall
Spring
Summer
Which education certificate program are you interested in?
*
Early Childhood Certificate Program (C55220)
Early Childhood Administration Certificate Program (C55850)
Infant/Toddler Care Certificate Program (C55290)
Early Childhood Diploma (D55220C)
Early Childhood Associate (A55220C)
Early Childhood Associate (A55220N) -Non-Licensure Path
Associate in Arts in Teacher Preparation (A1010T)
Associate in Science in Teacher Preparation (A1040T)
Associate in Early Childhood Licensure Path(A55220L)
Required
By signing your legal first and last name below, you are indicating that you agree to and are able to meet all of the application criteria for this program as stated above.
*
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of McDowell Technical Community College.
Report Abuse
Forms
