Child Behavior Certification Program Application

If you have any questions or concerns before completing the application, please feel free to email us at:

info@theearlyyears.ca

Child Behavior Certification Program Application

"*" indicates required fields

PERSONAL INFORMATION

Name*

First and Middle (if applicable) Last

Full Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Home Phone*

Cell Phone*

Your Email*

Date of Birth*

Marital Status*

How many children do you have?

If so, what are their ages?

EDUCATION, TRAINING AND EXPERIENCE

College / University:

School Name*

Number of Years Completed*

Degree / Diploma Earned*

Vocational School:

School Name

Number of Years Completed

Degree / Diploma Earned

Have you trained and/or received any other certifications?*

If so, please name the certificates and years completed:

Are you currently employed? Please specify your current occupation*

SO WE CAN GET TO KNOW YOU BETTER:

What do you hope to gain from this training?*

What is your primary reason for taking this training?*

Do you intend to specialize in behavior full-time or part time?*

What is your goal for the number of clients you would like to work with: weekly/monthly?*

Do you have financial goals regarding this career?*

Have you read through The Early Years mission statement and philosophy and are you in agreement?*

Additional comments and questions (please share any information or thoughts you feel would be beneficial as we consider your application for this specialty):

Lastly, can you say that the timing is right, that you are looking forward to an opportunity for ongoing learning, becoming a member of a learning community and helping children and their families to thrive?

Thank you! For taking the time to thoughtfully answer these questions. Let’s have a conversation, I want you to feel 100% comfortable and excited, to have confidence knowing this is a program, a path I want to pass on to you. After receiving your application I will email you and set up a time for a short chat.

Tuition Fees: $3500.00.
Next Child Behavior Certification Program Session 16-Week certification program begins: September 17th 2024. Classes are 2 hrs in duration and will be held at 1:00pm & 8:00pm EST (on alternating weeks).

Deposit: $350.00 Required upon acceptance of application.

Child Behavior Certification Program Application

If you have any questions or concerns before completing the application, please feel free to email us at: