Thank you for registering for professional development with One Place. Please direct all training questions and concerns to Shannon Niro, Early Education Administrative Coordinator at shannon.niro@oneplaceonslow.org

Question Title

* 1. Name

Question Title

* 2. Email Address- this email address is where you will receive your link to access training and your training certificate.

Question Title

* 3. Sign me up to receive email updates about One Place!!

Question Title

* 4. Primary Telephone Number

Question Title

* 5. Alternate Telephone Number

Question Title

* 6. Age

Question Title

* 7. Gender

Question Title

* 8. Race/Ethnicity

Question Title

* 9. Are you military affiliated? (Active Duty, Veteran, or Dependent)

Question Title

* 10. Employer/Child Care Facility Name

Question Title

* 11. Child Care Facility Type

Question Title

* 12. County of Employment

Question Title

* 13. Early Educator Job Status

Question Title

* 14. Age Group of Children you Serve
(check all that apply)

Question Title

* 15. Number of Children you Served by Age Group (all sections must be filled):

Question Title

* 16. If you are you a PARENT attending this training and NOT an Early Educator. How many children do you have 0-5 years old?

Question Title

* 17. I wish to register and submit payment for Darkness to Light(Online)-on June 3, 2025-6:00 PM to 8:30 PM

You’ll enter payment info after the survey.

Question Title

* 18. Special Instructions (Any allergies, hearing/sight barriers, language barriers, etc that the instructor should be aware of. All information will be kept confidential)

T