PARTNERS IN PRACTICE Application Form I f you find yourself interested in what we strive to accomplish, and would like to become a member, please fill out the application form and send it to us.

Name
Address
Postal/Zip code
Phone
Email

Application for:
PIPnet mentoring pair training. (Information on training, go to "who we are" , and click on "Become a part of the Partners In Practice Project")

Number of years in your early childhood practice
Select one of the following options Under 1 year 1 - 2 years 2 - 5 years 5 years or more

Do you have any early childhood practice credentials,
i.e. ECE diploma from Niagara Community College, Ontario?


What is a brief description of your workplace?


How many children do you have in your class?
Select one of the following options Under 10 children 10 - 20 children Over 20 children

How old are the children in your class?
If other, please specify what age range applies.
Select one of the following options Infants 0-18 mos Toddlers 18-36 mos Preschoolers 3-5 years School Aged   Age

Do you have any co-workers in your classroom? If so, how many?
Select one of the following options Yes, I have 1 co-worker Yes, I have 2 - 5 co-workers Yes, I have 6 or more co-workers No, I don't have any co-workers





Please link to the code of ethics for being part of a mentoring pair on PIP Net by clicking here. download, Print off a copy, sign, date and send to Partners IN Practice, 100-1200 Tower RD., Halifax, Nova Scotia, Canada, B3H 4K6.

|

Who We Are

|

Resources

|

Newsletter

|

Back

|