Covid-19 Provider List
(A.K.A Montessori Heroes)

Connecting Montessorians to Children

Question Title

* 1. Contact Information (to be shared with PNW Montessori Schools and their families only)

Name

City/Town

State/ Province

Email Address

Phone Number

Question Title

* 2. Select the type of role you are available to play (select all that apply)

Provide care for a child at their home

Provide care for a child at my home

Provide care at a school for emergency personnel

Other (please specify)

Question Title

* 3. What is your training/expertise?

I am a trained guide

I am an experienced support person (over two years of Montessori experience in classroom or aftercare)

I am relatively new to Montessori but have plenty of experience working with children

Other (please specify)

Question Title

* 4. Which age level are you comfortable working with? (select all that apply)

Infants (0 - 12 months)

Toddlers (12 to 36 months)

Primary (30 months to 6 y/o)

Elementary (1st to 6th grade)

Adolescents (7th grades and older)

Other (please specify)

Question Title

* 5. Enter the general geographic area(s) where you would be available for subbing? (add details in the comments section - as needed-)

NE Portland (Metro)

NW Portland (Metro)

SW Portland (Metro)

SE Portland (Metro)

SW Washington/ Vancouver

Southern Oregon

Central Oregon

Eugene Metro Area

Albany/Corvallis

Salem Metro Area

The Gorge

Northeast Oregon

Southern Coast

Northern Coast

Other (please specify)

Question Title

* 6. Is your background check up to date?

Yes

I don't know / I'm not sure

Covid-19 Provider List (A.K.A Montessori Heroes)

Connecting Montessorians to Children

Question Title

* 1. Contact Information (to be shared with PNW Montessori Schools and their families only)

Question Title

* 2. Select the type of role you are available to play (select all that apply)

Question Title

* 3. What is your training/expertise?

Question Title

* 4. Which age level are you comfortable working with? (select all that apply)

Question Title

* 5. Enter the general geographic area(s) where you would be available for subbing? (add details in the comments section - as needed-)

Question Title

* 6. Is your background check up to date?

Covid-19 Provider List
(A.K.A Montessori Heroes)