CDA Assessment Scholarship 2021-2022 Question Title * Contact Information First Name Last Name Employer: Child Care Program Child Care ProgramLicense Number CDA Council CustomerID Number* Personal Email Address *This 7-digit number is found in your online account with the CDA Council. It is not your certificate number. Question Title * Please upload a copy of your CDA Course certificateOnly PDF, DOC, DOCX, PNG, JPG, JPEG, or GIF files can uploaded PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only. Choose File Choose File No file chosen Remove File Please upload a copy of your CDA Course certificateOnly PDF, DOC, DOCX, PNG, JPG, JPEG, or GIF files can uploaded Policies and Statements: If awarded an assessment scholarship and the recipient does not complete the process by the due date listed on their CDA account, the applicant must submit another application and commitment fee to receive another scholarship. If awarded an assessment scholarship and the recipient is not successful in attaining the CDA credential or fails to complete the requirements by the deadline set by the CDA Council, another assessment scholarship may not be awarded. We attest that the applicant lives or works in one of the following 13 counties: Austin, Brazoria, Chambers,Colorado, Fort Bend, Galveston, Harris, Liberty, Matagorda, Montgomery, Walker, Waller, and Wharton. We attest that the applicant is a current employee at the center listed on the application. The candidate agrees to give permission to the Council for Professional Recognition to release their CDA assessment status and results to Collaborative for Children. We understand that maximum value of the scholarship is $425 for online submission ONLY. If submitted through mail, we are responsible for the additional processing fee. We attest that the applicant has completed all CDA course requirements and is ready to be assessed. We understand that this application is not transferable to another person and commitment fee is non-refundable. We understand that if the applicant is not successful in attaining the CDA credential or fails to complete the requirements by the deadline set by the CDA Council, another assessment scholarship may not be awarded. We understand that if the applicant does not redeem the scholarship by the due date attached to the voucher, the applicant must submit another application and commitment fee to receive another scholarship award. Upon receiving your official CDA Credential in the mail, you agree to send a copy of it to Tamira.Campbell@wrksolutions.com. Question Title * I acknowledge that I have read, understand, and will abide by the above named policies,procedures, statements, and instructions. Yes Submit