Merritt College Early Educator Apprenticeship Application - City of Oakland Application
Through an innovative partnership with City of Oakland Head Start, YMCA of the East Bay,  and Merritt College we are proud to present an apprenticeship program designed to train and prepare participants who have an interest in working with young children 0-5 and providing their professional knowledge, skills and practice! If you are interested, please apply as classes are filling up fast!! Please be advised this the City of Oakland application.
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Referred Agency  *
First Name  *
Last Name: *
Best phone number to reach you: *
Best E-mail to reach you: *
Mailing Address Street *
City, State, Zip code: *
How did you hear about the Apprenticeship Program? Who referred you? *
Are you authorized to work in the United States? *
Are you at least 18 years old? *
Gender: *
Race and Ethnicity: *
Hispanic Status: *
What is the primary language you speak at home? *
What other languages are you fluent in? *
Personal Education Level: *
School Name/ Location
Major/ Area of Study: (if applicable)
Degree Type: (if applicable)
Total Units Completed: (if applicable)
What is the highest level of Early Childhood Education or Development Education you have received?
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Child Development Permit Type: (if applicable)
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Permit Expiration Date: (if applicable)
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Are you currently employed? *
If "Yes," Name of your employer/ Type of Business:
If you are working do you have time to do field placement hours?
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If you are currently unemployed, do you wish to be employed?
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If you have worked in the YMCA or City of Oakland Head Start before, list location, date, and position:
What services do you need to participate successfully in the program? (Check all that apply)
Have you received CalWORKs in the last 24 months? *
IF you have received CalWORKs in the past 24 months, what is your case number?
IF yes, in what COUNTY are you register to receive CalWORKs?
Do you have child(ren); *
If yes, what is/are the date(s) of birth:
If you have child(ren) do you have child care for your child(ren)? If so, where?
Are you a Head Start parent? If so, what site?
Why do you want to be in the Merritt College Early Educator Apprenticeship Program? *
What is your professional goal - where do you see yourself in 1 to 3 years from now? *
List three persons not related to you who would have knowledge of your work performance within the last three years. Please include Name and Contact Information (i.e. email and phone number) *
Signature and Date: I hereby certify that the information furnished on this application is accurate and complete to the best of my knowledge. I understand that if I have knowingly misrepresented my academic qualifications, the consequences of any misrepresentation on my application may result in denial of admission, rescinding of admission, suspension, and expulsion. I agree that if admitted I will abide by the rules and regulations of the university and  Apprenticeship program. *
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