All Domains Trainer Application Complete this form if you are applying to train all seven Early Learning Guidelines domains. * Required

1. First Name *

2. Last Name *

3. Street Address (home) *

4. City *

5. State *

6. Zip Code *

7. Phone Number *

8. Alternate Phone Number

9. Language(s) you are willing to train in * Check all that apply. English Spanish Other:

Qualifications

10. I meet the minimum education qualification https://goo.gl/P2kNKi * Mark only one oval. Yes No, STOP and please contact Emily Nash at 402-557-6893 or [email protected] 11. Select your highest level of education attained in early childhood education or related field: * Mark only one oval. NAEYC Associates Degree Equivalency (college transcript required, email a copy of your transcript to [email protected]) AA CDA BA/BS MA/MS PhD 12. College or University Attended (including city/state) *

13. Year Graduated (N/A if not applicable) *

14. Area of study major/minor *

15. I meet the minimum experience qualification https://goo.gl/P2kNKi * Mark only one oval. Yes No, STOP and please contact Emily Nash at 402-557-6893 or [email protected] 16. I have read and understand the Nebraska Early Learning Guidelines Birth to Five * Mark only one oval. Yes No, STOP and please contact Emily Nash at 402-557-6893 or [email protected] 17. I have experience training adult learners * Mark only one oval. Yes No, STOP and please contact Emily Nash at 402-557-6893 or [email protected]

Early Learning Connection Partnership Regions

18. Please select ALL regions in which you are willing to train: * Check all that apply. Central Region High Plains Region Norther Region Omaha Region Panhandle Region Platte Valley Region Southeast Region

Supplemental Questions 19. Select the Nebraska Early Learning Guidelines training you have attended: * Check all that apply. Approaches to Learning Creative Arts Health and Physical Development Language and Literacy Development Mathematics Science Social and Emotional Development None

20. Select the Nebraska Early Learning Guidelines domains you have trained (if any): * Check all that apply. Approaches to Learning Creative Arts Health and Physical Development Language and Literacy Development Mathematics Science Social and Emotional Development None

For the following questions, please limit each response to 100 words or less. 21. Describe training you have conducted: *

22. Describe how you have contributed to the selection/implementation of curriculum or learning activities in an early childhood program: *

23. Training audiences often include educators with varied years of experience, educational levels, settings, budgets, etc. Describe how you would tailor your training presentation to engage all participants: *

24. AUDIENCE COMPOSITION: Experienced Family Child Care Home Providers and newly hired Child Care Center Staff. LEARNING OBJECTIVE: The learner will understand the connection between materials and learning. CHALLENGE: A child care center staff mentions they have a dedicated infant room with space for infants to move about freely. A family child care home participant responds that they do not have space specifically dedicated to infants and is unsure they are meeting the needs of the infants in their care. ***Address both audiences and give suggestions relevant to each setting while incorporating the learning objective listed above.*** *

25. AUDIENCE COMPOSITION: Child care center staff from public and private settings. LEARNING OBJECTIVE: The learner will identify strategies to address challenging behaviors. CHALLENGE: Teachers express frustration in the lack of continuity of behavior management in the center versus in the child’s home. ***Address both audiences and give suggestions relevant to each setting while incorporating the learning objective listed above. *** *

26. In the following paragraph describe the experience and education you have that qualifies you to train the domain(s) you have selected. *

Resume Copy and paste resume below 27. Copy and paste resume below *

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