Application
Surrogate Parent for NH Birth to 3, Family-Centered Early Supports and Serviced Training Program

1. Program Overview

Thank you for your interest in volunteering to serve as the decision-maker for an infant/toddler in NH's Birth to 3 system, Family-Centered Early Supports and Services, when a parent is unavailable or unable to participate. In order to apply to the Surrogate Parent for NH Birth to 3 Training program you must:

Be at least 21 years of age
Have professional or personal experience with young children
Complete this application process, including providing at least 3 references (submitted through this application)

After the Part C Office receives your application and checks your references they will set up a phone or virtual meeting to discuss the training program and commitment. Please note that not all applicants may be selected to participate in the training program. If you have any questions or concerns you'd like to discuss prior to applying, please contact (INSERT CONTACT INFORMATION).

Upon acceptance into the training program, the following will be required to be certified as a Surrogate Parent for NH Birth to 3:

Complete a Registries Check
Complete a Conflict of Interest Disclosure and Assurances form
Complete all Learning Modules and other Training Program requirements
Score an 80% or higher on the Surrogate Parent for NH Birth to 3 Final Exam

Thank you for volunteering to support young children who are at risk for or have a developmental delay/disability in NH! We look forward to including you in our circle of support.