Shade Tree Learning
Director Credential Application
Statement of Understanding and Enrollment Agreement

Shade Tree Learning agrees that: 
1.We will offer a professional development program that will allow time for participants to put their knowledge into practice through assignments, small group work and demonstrations.
2.Provide a program that follows current Health and Human Services Minimum Standards and follows the National Association for the Education of Young Children. 
3.Provide a program that does not discriminate based on race, sex, ethnicity, religion, national origin or age.
4.Provide a program that protects participant’s privacy and holds all records in confidentiality so that the records are only accessible to specific individuals with the State of Texas Child Care Regulation.

I agree that as a participant: 
1.I meet eligibility criteria
2.I will attend and participate in all required components of this program.
3.I understand that I am only allowed to miss one day of class and that I will have make up work that must be completed before I can receive my test for credential.
4.I understand that I must score at least an 80% on all projects and test.
5.I will follow all policies and procedures of this program.
6.I will notify Shade Tree Learning of any change in name, address or telephone numbers.
7.I understand that registered participants must cancel 2 weeks prior to the start date of class and will receive a full refund. Any participant that cancels after 2 weeks prior to the start date of class will only receive credit towards any classes or training modules available at www.shadetreelearning.org. NO REFUNDS WILL BE GIVEN.
8.I understand that I am not able to start until the full payment of is received.
9.I understand that this credential must be renewed every two years on or before the notification of expiration. I understand to receive the renewed certificate I must provide 45 hours of training in Child Development and 25 hours of administration of training, an explanation of all licensing inspections during that period, CPR and First aid, plus a fee for renewal. 
10.I understand that my credential can be suspended or revoked if I fail to maintain a center in good standing with Child Care Licensing, fail to complete required annual training, and fail to submit renewal application and fee.

By signing below, I agree:

1. I have read this entire document and agree to abide by it. 
2. I understand that I have 6 months to complete the course. 
3. I have never been convicted of a felony offense or misdemeanor classified as: an offense against the person or family, a public indecency, or a felony violation of any law intended to control the possession or distribution of any substance included as a controlled substance in the Texas Controlled Substance Act. 
4. I have read the Statement of Understanding and Enrollment Agreement. 
5. I have read and understand the STATEMENT OF UNDERSTANDING AND ENROLLMENT AGREEMENT. 
6. I have read and agree with the above requirements and certify that I have given accurate and truthful information. 
7. By entering your signature below, you state that all information is true and factual. Submission of registration does not guarantee enrollment in the Director Credential Course. Shade Tree Learning has the right to refuse any applicant for any reason. 
8. I understand that once the payment is made, I have to complete the program within six months.

Printed Name:

Signature:

Signature Date:

Please complete the application on the next two pages.

Application

Personal Information 
Name: 
Mailing Address: 
Cell # 
Email Address: 

Educational Background 
High School Name: 
Address: 
Date of graduation:                         or GED: 

College Name: 
Address: 
Course of Study: 
Hours Completed:                          Date of graduation: 

Licensed Childcare Experiences: 
Total number of years you have worked in licensed or registered childcare: 
Please list your last to first employment: 

Center Name: 
Center Address:
Center Phone Number
Employment dates: from     to  
Job title:

Center Name: 
Center Address:
Center Phone Number
Employment dates: from     to  
Job title:

Center Name: 
Center Address:
Center Phone Number
Employment dates: from     to  
Job title:

References 
Name: 
Address: 
Phone #: Email:  
Relationship: 
How long have you known them? 

Name: 
Address: 
Phone #: Email:  
Relationship: 
How long have you known them? 

Name: 
Address: 
Phone #: Email:  
Relationship: 
How long have you known them? 

Comments: