Parent Ambassador Application 2021 Survey

The Parent Ambassador program provides child care and mileage stipends to help support participation. Please be aware that at most of our face to face conferences, rooms are shared; this fosters networking among the Ambassadors and helps with our limited budget. We do not provide on-site child care at any of our trainings or events. It is your responsibility to recruit and/or secure a child care provider for each and every face to face training/meeting. Nursing non-mobile infants are welcome. Please consider your child’s growth and your commitment to nursing when applying. Nursing infants (0-12 months) very quickly grow into mobile and active toddlers. The spaces that we meet in are not suitable and safe space for toddlers.

All interested applicants must complete the application or download the questions and email complete answers to the questions by January 3, 2021 by 5:00 pm.

Follow up interviews will be scheduled for a time convenient for the applicant during the week of January 4-8, 2021.

Chosen Ambassadors will immediately begin coming together by conference call on January 25 to discuss the logistics of the first face to face meeting.

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* 1. Basic Info

Name:

Email Address:

Mailing Address:

City:

State:

ZIP:

Cell Phone Number:

Home Phone Number:

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* 2. Is/was your child/ren in: Mis ninos participan en:

Head Start

ECEAP

Early ECEAP

Early Head Start

Child Care

Early Services for Infant & Toddlers (ESIT)

Home Visiting - such as parents as teachers, nurse family partnership

Foster Care

I receive/have received Subsidized Child Care

Private Pay Preschool

Public School Preschool (Seattle PreK Program, Local School District etc)

Family, Friend & Neighbor Child Care

My child has not been in a formal early learning setting

If not listed above, please tell us about your experiences or programs you have participated in

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* 3. If your child is currently enrolled in a program, what is the name of it? / Your program/Su programa (example: Lewis County Head Start/ECEAP, Busy Bee Child Care Center, etc)

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* 4. What are the ages of your children? Check all that apply

0-3

4-5

5-9

9-12

12-18

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* 5. Why are you interested in being a Parent Ambassador?

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* 6. What special talents or skills would you bring to the Parent Ambassadors program?

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* 7. Tell us about your experience working as a team or within your community

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* 8. What does early learning mean to you?

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* 9. What does it mean for you to have a commitment to diversity? How have you demonstrated that commitment, and how would you see yourself demonstrating it?

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* 10. What is your Home Language?

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* 11. Are you bilingual? If so, what languages do you speak?

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* 12. Please share your race and ethnicity.
(We are committed to Parent Ambassadors being racially and ethnically diverse just as children and families are in the state of Washington. This information is not shared about individuals with any other group or entities including the government. Answering is not required but is helpful for use in determining representation of parents across the state.)

Native Hawaiian or other Pacific Islander

American Indian or Alaska Native

Asian or Asian American

Hispanic or Latino

Black or African American

White or Caucasian

Other (please specify)

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* 13. Anything else we should know about you?

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* 14. Please check if the following are true:

I can commit to a minimum of two conference calls each month on Mondays at 8:30 PM

I have daily access to internet and email. I can commit to checking and responding to the leadership team.

I have a cell phone with the ability to send and receive text messages.

I have limited minutes on my cell phone.

I can secure child care for my children in order to participate in EVERY face to face training.

I have an infant that I would need to bring with me to face to face trainings. (This does not affect your application, just info we need for planning purposes)

I am able to attend the five REQUIRED face to face meetings. If we are unable to meet in person due to COVID-19, I am able to attend virtually.
The meetings are scheduled for:

Feb. 24-25, 2021 - Olympia
March 19-20,2021 Federal Way
June 30-July 1st, 2021 - Ellensburg
October 1-2, 2021 - Location TBD
February 23-25, 2022 - Olympia

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* 15. How did you hear about this program? Did anyone refer you to this application? If so, who?

For more information, please contact April, april@wsaheadstarteceap.com, or 360.338.1362.
Para más información, por favor póngase en contacto con Katy, katy@wsaheadstarteceap.com, 425.453.1227. Ella habla español.