Application Instructions
Please read the following instructions carefully, you are responsible to meet all requirements and for submitting the correct verifying documentation. Please complete the application by printing legibly in ink. Incomplete or illegible applications will not be accepted.
Determine if you meet the minimum eligibility requirements to participate:
- Provide early care and education services for pay to children birth to five in the same state subsidized center for a minimum of 9 months between start date on or before September, and continuing through June to be eligible for AB212 funds; and
- Work a minimum of 15 hours directly with children birth to five; and
- Demonstrate you have or working towards an Assistant level Child Development Permit or higher issued by the California Commission on Teacher Credentialing, and
- Earn less than $60,000 annually in child care; and
- Apply for an AB212 stipend from only one county in California.
The AB212 Application must be submitted by May 11. You will only be eligible to submit coursework that is required for the ECE degree path you have chosen, at the college you are seeking a degree from. If you are choosing to apply for planned professional growth hours that lead to a Permit renewal or higher Permit, you will be required to submit a copy of your Professional Growth Plan with your application to illustrate you have met with a Professional Growth Advisor and completed your goals. All supporting documents will be due by May 11; verification of unit bearing college courses for participants that are enrolled in the Spring semester may be submitted no later than the second week in June.
Page 1: Application Information, all questions must be answered in full.
Questions 1-9
- Please make sure your mailing address is correct, this address will be the address we will mail your check to if you successfully meet all eligibility requirements.
- Required demographic information for statistical purposes and will not affect eligibility.
Experience, Education, and Permit Information.
Questions 10-17
- Question 11: you will need to register for the CA ECE Workforce Registry in order to receive your ID Number –all applicants will need to register to be eligible for a stipend.
- Question 12: should match your transcripts indicating past college courses you completed.
- Question 14: if you will apply for a degree this year, please indicate the type, example: AA in Child Development from Sonoma State.
- Question 15: this is your current Permit level issued by the California Commission on Teacher Credentialing.
- Question 16: if you will apply for a higher Permit or an upgrade, please list the level you will apply for and the date you submitted your application to the California Commission on Teacher Credentialing.
- Question 17: please let us know what college you are attending.
Page 2: Facility and Employment Information
Questions 18-31
- Please ask your director if you are unsure of the answer to any of the questions.
- Employment dates will be verified prior to stipend awards in June.
- Question #25: children with disabilities and other special needs refers to those children who: 1) are protected by the Americans with Disabilities Act (ADA); or 2) have or are at risk for a chronic condition whether physical, developmental, behavioral, or emotional and who also require educational, developmental, health, behavioral mental health, and related services and/or supports of a type or amount beyond that generally required.
- Sign this page and date.
W-9 Form
- All applicants must complete and submit the W-9 form with the application packet.
Child Development Permits
- Entry level applicants are required to show proof of application for an Assistant level Permit and transcripts illustrating the ECE units obtained for eligibility to apply for the Permit.
- All other applicants must submit a copy of a valid Child Development Permit, Assistant level or higher. If your Permit is expired at the time of stipend distribution and you do not submit evidence that you have applied for a renewal, you will be ineligible to receive a stipend.
- Child Development Permits may be applied for by contacting the Credentials Specialist at the Napa County Office of Education.
Professional Growth Hours
- The Napa AB212 program is designed to support Child Development Permit holders and their individual professional growth activities.
- To be eligible for a stipend for professional growth activities you will need to submit certificates of attendance or Verification of Hours Spent on approved Professional Growth Activity. Copies of certificates must include: your name, title of activity, date of activity, number of professional growth hours and a signature from the training organization. Copies must be clear and legible. You must submit a total of 21 hours per year to be eligible for this option; and
- You must submit a copy of your updated Professional Growth Plan with your evidence of obtained activities by May 11. The updated Plan must include your Advisor’s initials indicating they reviewed your completed activities.
College Transcripts and Verification of Required Coursework
- Submit evidence from the college you are seeking a degree from that your coursework is required for degree completion. This can be achieved through an Education Plan or other school documentation that lists required course options for the specific degree pattern.
- Complete college coursework with a grade of “C” or higher.
- Submit unofficial transcripts or printout from the college you attended. Documentation must include your name, dates and grades.
If you are enrolled in a Spring COLLEGE course, you will have until June 15 to submit verification of completion. Fall coursework verification is due May 18.