Program Application - August 2020
If you have questions or need additional information, please call CDL at 504-840-9786 or email
Email address *
Personal Information
Name: (first, middle initial, last) *
Your answer
Last 4 SSN: *
Your answer
Home Address: (street, city, zip) *
Your answer
Cell Phone: *
Your answer
Additional Contact Number: *
Your answer
Do you have access to a computer outside of work? *
Employment Information
Employer: *
Your answer
Address: *
Your answer
Phone: *
Your answer
Start Date at Center: *
Employment Status: *
Position: *
Ages Taught: (Check all that apply.) *
Do you have a high school diploma or GED? *
Do you have a college degree? *
If yes, degree received:
Your answer
Area of study:
Your answer
Early Childhood Experience
How long have you been employed in the early childhood field? *
Which age groups have you worked with? (Check all that apply.) *
Have you started the CDA certification process, applied for a CDA, or received a CDA credential in the past? *
If yes, please explain?
Your answer
Do you already have clock hours that you have obtained for the purposes of getting a CDA? *
If yes, approximately how many hours do you have?
Your answer
Assurances and Signature
I certify that my answers are accurate and complete to the best of my knowledge and that I understand that false or misleading information on my application or within the required documentation may result in the rejection of my application. *
Incomplete applications will not be accepted.
A copy of your responses will be emailed to the address you provided.
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