Professional Environmental Educator Certification 2022-23 Course Application Form

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Enrollment in the course is limited to the first 20 applicants who submit the completed application. Additional applicants will be accepted from a waiting list if places in the course become available. Accepted applicants will lose their reserved place if they do not submit the Workshop 1 registration fee, course materials fee, and enrollment forms by October 14, 2022.

Tentative Workshop Schedule:
• Workshop 1: October 28-29, 2022, Maywoods, Crab Orchard
• Workshop 2: December 9-10, 2022, JM Feltner 4-H Camp, London
• Workshop 3: February 24-25, 2023, Flaget Center, Louisville
• Workshop 4: April 14-15, 2023, Cave Research Foundation, Cave City

Registration fee: $225 per workshop
• Lodging and meals are included in the fee.
• The payment for Workshop 1 is due on September 30, 2022.
• For each subsequent workshop, payment is due one week before the workshop.

Course materials fee: Up to $90
• Due by October 14, 2022
• $30 each for any of the Project WET, Project WILD, or Project Learning Tree curricula in which you are not already certified.

Enrollment materials
• Enrollment form
• Self-assessment
• Signed agreements (code of ethics, policies and procedures, etc.)

The Kentucky Environmental Education Council is committed to providing equal opportunities to participate in this course for all persons regardless of race, color, national origin, age, religion, sex, gender identity, sexual orientation, or disability.

Applicant information

Course participants must be 18 years of age or older and have completed a high school diploma or GED, or higher. Please check the boxes below to confirm: *

I am 18 years of age or older

I have at least a high school diploma or GED

Required

Your name *

Mailing address *

Phone number *

Email address *

Work\volunteer experience and certifications

This information will help us understand the background and needs of our course participants. No particular experience or certifications are required.

Please list your work and volunteer experience, including the organization, your position, and the dates. Start with your current position, if any, and list no more than 4 positions, by most relevant and/or recent. *

Please list your educational experience and certifications. *

Check if you are certified in the following curriculum projects, and have the current version of the curriculum book. Leave the box unchecked if you are certified, but your book was published prior to the year listed, or if you are not certified in the curriculum.

Project Learning Tree (2021)

Project Wet (2011)

Project Wild (2018)

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