Fisher Childhood Apprenticeship Program(FCAP)

Please complete this electronic form if you are interested in the becoming a registered apprentice enrolled in FCAP. Your information will be reviewed and we will communicate next steps shortly after form submission.

Email Address

First Name

Middle Name

Last Name

Birthdate

Private Protection Policy:

We are committed to protecting your privacy.

Upon receiving the secure transmission of your Social Security Number, it is immediately encrypted. Only the last 4 digits of your Social Security Number are available in plaintext for identification and account matching purposes. Your Social Security Number is available for decryption only by those officials who oversee automated loading of personal information into student information systems, and only for that limited purpose.

Our databases are actively monitored and are firewalled to ensure the protection of your personal information, and we employ all industry-standard safeguards.

SSN:

Mobile phone number:

Mailing Address

Country

Street

City

Region

Postal Code

What is your race?

Are you a veteran?

Do you have a documented disability?

What is your gender identity?

What is your Professional Qualifications Registry # (PQR)

Please select which organization you are employed at?

How long have you been employed at your current position?

In which type of child care setting would you like to work?

Which state certification are you interested in?

Do you have access to a laptop or computer to participate in these classes?

Do you have regular/daily Internet access?

Participants must complete free online college courses to obtain EEC teacher certification. Are you able and willing to meet this requirement?

Can you read, write and speak English?

What is your highest level of education?

Are you interested in completing a college degree?

Please type your Personal Statement: Describe your interest in pursuing a career in early childhood education and care. (250 words)

Please upload your transcript:

Please upload an Apprentice Photo(face forward, headshot only, no hats, sunglasses or face coverings) (2x2 JPEG format ):