Application Instructions:

All staff of Pennsylvania Department of Human Services (DHS) certified child care programs and Family Centers are eligible to apply for ECE Summit Scholarships.  Scholarships are valid for Summit registration fees and hotel accommodations only.  Scholarships will be awarded based on a regional distribution and are subject to availability of funds. 

**Please be prepared to share a hotel room with another scholarship recipient from the same program. (some exceptions may apply)**

Please complete the application below entirely.  Applications must be submitted by Friday, August 18, 2017 at 11:59 PM EDT.  Applicants will be notified of their status via e-mail by Friday, August 25th.  More information on the registration process will be provided at that time. 

Questions?  Contact Maureen Murphy at (717) 657-9000 or maureen.murphy@pacca.org.  

* 1. First Name:

* 2. Last Name:

* 3. E-mail Address:

* 4. Employer/Program Name:

* 5. Employer/Program Address:

* 6. In what county is your program located?

* 7. Daytime Phone:

* 10. My Director has given consent for me to apply for a scholarship.

* 11. Please provide your director's contact info|

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