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Instructions:

Advance payment is required. If paying with cash please bring the exact amount to the SSDC office. Checks should be written to SSDC. If a training states “pay the trainer” you still need to send in the registration form and pay trainer night of class. If your money is received after a workshop is full or if a workshop is cancelled you will be informed by phone; the rescheduled date will be given to you or you may choose another workshop. Smart Start of Davidson County is not responsible for registration forms or fees lost in the mail or not delivered on time. Please remember your workshop location and time. If you register and do not attend no refund or credit will be given. You will not be able to switch classes. Trainings fill up fast; so please turn in registration as soon as possible. Doors are closed 15 minutes after start time.

|Training Topics |

|ITS SIDS |

|Meets DCDEE safe sleep training for teachers and/or administrators while working with infants. Participants will learn about best practices and receive |

|information how to create a safe sleep policy, how to use waivers, hear updated research about SIDS, and local health and safety resources as well as learn what|

|to do if you come upon an unresponsive infant and how to conduct drills. |

|2HRS. Chunda Teal or Sherry Brannon |

|Fire Safety |

|Find out how to prevent fires and the correct course of action to take in case of a fire. 1.5 HRS. Shane Draughn |

|Pay trainer night of training - PLEASE BRING CORRECT AMOUNT |

|Emergency Preparedness & Response |

|The new Emergency Preparedness and Response (EPR) in Child Care Training provides early educators with information and tools to prepare for many types of |

|emergencies. The EPR in Child Care Training addresses new NC Child Care Rules on emergency preparedness, current best practice recommendations, and guidance on |

|completing the online EPR Plan. The EPR Plan template can be found on the North Carolina Emergency Management website. 2.5HRS. Alanna Hege |

|Environment Rating Scale ITERS-R / ECERS-R |

|Come find out How to score the ERS and what is needed in each center. Great for new teachers who need or those that need a refresher on how to score. Class is |

|limited to 25 participants. Sign up Early ( 2 HRS. Gina Collins/Alanna Hege |

|More than Baby Talk! This training will focus on practices that early childhood educators can use to support the development of language and communication |

|skills of infants and toddlers. Research supports the importance of adult-child interactions for infants and toddlers, we will look at the types of interactions|

|that research suggests best promotes language and communication skills. |

|2HRS. Gina Collins/Alanna Hege |

|CSEFEL – Center on the Social/Emotional Foundations for Early Learning (for Infants/Toddlers and Preschool) Separate Trainings |

|An Overview of the CSEFEL Pyramid Model) Are you hearing the terms “CSEFEL” or “pyramid model” and are not really sure what they mean? Do you wonder how a |

|pyramid relates to challenging behaviors? Are you considering attending a CEU level learning event about social-emotional development but are afraid to make the|

|time commitment until you know a little more? If you answered “yes” to any of these questions, come to this overview of the CSEFEL Pyramid Model. During this |

|session, participants will gain a deeper understanding of the importance of healthy social emotional development in young children, factors that influence |

|behaviors, and causes of challenging behaviors in young children. A variety of activities will help participants understand each component of the Pyramid Model |

|and how it can be used to promote healthy social behaviors and prevent challenging behaviors in classrooms. 1 CEU or 10 Contact Hours |

|Alanna Hege (Infant/Toddler CSEFEL) / Gina Collins (Preschool) Material Incentives Given to QSS Sites only |

|Playground Safety |

|The North Carolina playground Safety training was created to provide the necessary knowledge and tools to ensure all childcare centers meet the DCDEE |

|requirements and provide a safe and fun environment for all. 4HRS. Vicki West |

|NCFELD – Foundations |

|This is a 5-hour course designed to provide participants with an introduction to Foundations, North Carolina’s new Early Learning & Development. Must attend |

|both sessions in order to receive credit. |

|The revised Foundations spans birth to age 5 and includes goals, developmental indicators, and strategies in five developmental domains: |

|•Approaches to Play and Learning •Emotional and Social Development •Health and Physical Development •Communication and Language Development •Cognitive |

|Development Please bring a copy of the foundations book and a completed lesson plan. The 2nd session will focus on how to align lesson plans to Foundations. |

|Class is limited to 25 participants. |

|.5 CEU or 5 Contact Hours Chunda Teal /Alanna Hege |

| Literacy – Fostering Language Development Part I .5 CEU’s/ 5HRS |

|In this workshop, participants will: gain a deeper understanding of children’s language development and its relationship to their thinking; learn more ways to |

|encourage and support children’s vocabulary development; acquire strategies for developing children’s listening and speaking skills throughout the day; and |

|examine ways to promote children’s language and thinking through good literature. Applicable for NCPK literacy requirement. Chunda Teal and Vicki West |

PAGE 2

Instructions: Advance payment is required. If paying with cash please bring the exact amount to the SSDC office. Checks should be written to SSDC. If a training states “pay the trainer” you still need to send in the registration form and pay trainer night of class. If your money is received after a workshop is full or if a workshop is cancelled you will be informed by phone; the rescheduled date will be given to you or you may choose another workshop. Smart Start of Davidson County is not responsible for registration forms or fees lost in the mail or not delivered on time. Please remember your workshop location and time. If you register and do not attend no refund or credit will be given. You will not be able to switch classes. Trainings fill up fast; so please turn in registration as soon as possible. Doors are closed 15 minutes after start time.

Complete one form per participant (complete the entire form)

|PLEASE RETURN REGISTRATION FORM by mail or drop off at the Smart Start Office. Faxed registration will only be accepted if it is a Pay the Trainer training only. Please complete in full |

|page 2 & 3 and return with payment if applicable. |

|306 East US Hwy 64 |

|Lexington NC 27292 |

|FAX#: 249-6687 |

.

|First Name: (use real/biological name) not nickname |Last Name: |Phone# with Area Code: |

| | |( ) _________ - __________________ |

|□Male □Female |Race: □African American □Asian □Caucasian □Hispanic/Latino □Native American □Multiracial |Primary Language: |Age: |

| |□Other________________ | | |

| | | |Date of Birth:___ /___/___ |

| | | |Month Day Year |

|Address: |

|Email Address: |Specify number of children in each age group that you work with: |

| | |

| |Birth-2yrs |

| |3yrs – 5yrs |

| |5yrs – 12yrs Schoolage |

| | |

| |# |

| |# |

| |# |

| | |

| |* Directors or Floaters do not complete |

|I am employed at: | |

|I work with: □Infants □Toddlers □ 2’s □3’s □4’s □SA Group (mark X for age group you work with) | |

|County in which I am employed: |Facility Star Rating: □Unlicensed |

| |□GS-110 □1 Star □2 Star |

| |□3 Star □4 Star □5 Star |

|Position Held: □Administrator □Asst. Administrator □Lead Teacher □Asst. Teacher □Floater □FCCH □Program Coordinator (Sch. Age) □ Group Leader (Sch. Age) □Sub| |

|□Other: Please Specify: __________________ | |

Complete one form per participant Page 3

|First Name: |Last Name: |

|Training Title |Date of Training/Time |Select Training (X) |Cost $$ |

|More than Baby Talk! |August 6, 2019 | |$5.00 |

| |6:30-8:30PM | | |

|ITS SIDS (Sudden Infant Death Syndrome) |August 8, 2019 | |$5.00 |

| |October 24, 2019 | |Choose one date |

| |6:30-8:30PM | | |

|Center On the Social Emotional Foundations of |August 15, 22, 29, & September 12, 2019 | |$20.00 |

|Early Learning (CSEFEL) For Infant/Toddlers |6:30-8:30PM | |Must attend all 4 |

|(Incentives given to QSS sites only) |1 CEU / 10 Hours | |sessions |

|Center On the Social Emotional Foundations of |August 20 & 27 September 10 & 17, 2019 | |$20.00 |

|Early Learning (CSEFEL) For Preschool |6:30-8:30PM | |Must attend all 4 |

|(Incentives given to QSS sites only) |1 CEU / 10 Hours | |sessions |

|Playground Safety – This will be held at Fleshman |September 21, 2019 | |$10.00 |

|Pratt Education Center in Thomasville NC |9:00-1:00 | | |

| |Fleshman Pratt Education Center | | |

|ERS (Environment Rating Scale) Getting to Know |September 24, 2019 | |$5.00 |

|ERS and How to Score |6:30-8:30PM | | |

|Emergency Preparedness and Response (EPR) |September 26, 2019 | |$10.00 |

| |6:00-8:30PM | | |

|Fire Safety |August 13, 2019 | |$10.00 |

|Pay trainer night of training - PLEASE BRING |October 29, 2019 | |PLEASE BRING CORRECT |

|CORRECT AMOUNT |6:30-8:00PM | |AMOUNT |

| | | |Choose one date |

|North Carolina Foundations of Early Learning and |October 8 & 15, 2019 | |$15.00 |

|Development (NCFELD) |6:30-8:30PM | |Must attend both |

| |.5 CEU’s | |sessions |

|Fostering Language Development ( Applicable for |December 3 & 10, 2019 | |$15.00 |

|NCPK Literacy Requirements) |6:30-8:30PM | |Must attend both |

| |.5 CEU’s | |sessions |

| | |GRAND TOTAL |$ |

|For Office Use Only: Date Received:__________ Smart Start of Davidson County |

| |

|306 East US Hwy 64 |

|Lexington NC 27292 |

|Check#__________Cash_____ MO_______ Receipt#____________ Phone: 336-249-6688 |

|Confirmation Sent:______ Date:___________ Fax#: 336-249-6687 |

|Email:_______ Phone Call:_________ |

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