Shared Services Hub Application

Shared Services Hub Application
Thank you for your interest in joining the Imagine Institute Shared Services Hub! Please provide the information below. We will make every effort to assign you to a cohort that meets your needs.

Para ver este formulario en otro idioma, haga clic en la bandera de EE. UU. arriba.

Marabtaa inaad xog aruurintan ku aragto luqad kale? Fadlan dhagsii calanka Mareykanka ee kore.
Name*

First NameLast Name
Email*
example@gmail.com
Phone Number*
Please enter a valid phone number.
Zip code*

Please provide at least one of the following ID numbers:*

	Your Identification Number
FamLink ID
STARS ID
SSPS Number

About Shared Services
The Shared Services Hub connects child care providers to resources and services to help grow their businesses, build bonds with fellow providers, and access free training and expert advice. Providers can choose from two tracks, based upon their interests and available time.

The Discovery Track is best suited for providers and child care center directors who want a self-directed, flexible experience with no time commitment. It is open to all active licensed family child care providers and independent child care center directors in Washington State. All applicants will be accepted.

The Connect Track offers comprehensive support for providers looking to build community and receive one-on-one and small group professional development. This track requires a minimum time commitment of approx. 3 hours per month.

If demand exceeds space for the Connect Track, priority will be given to:
- New providers
- Graduated Imagine U interns
- Providers in rural communities
- Providers serving children on subsidy
- Providers who speak a high-need language
- Providers serving children impacted by trauma
- Providers serving children experiencing poverty
- Child care centers with a capacity of 80 or fewer children
Which Shared Services Track are you applying for?*

Discovery Track- tools and support without a time commitmentConnect Track- tools, support, and training within a cohort
What type of child care provider are you?*

Licensed Child Care CenterLicensed Family (Home) Child Care
What is your current role within your child care?
What other roles have you held in ECE?
How many total years have you been in the field of ECE?*

16+ years11-15 years6-10 years3-5 years0-2 years

Thank you for your interest in joining the Connect Track! All Communities of Care are currently full. Please complete the rest of this form to join our waitlist. We will contact you when there is an opening in a Community of Care that meets your needs.

All providers are welcome on the Discovery Track! You will be accepted into the Discovery Track while you wait for a Connect Track opening.
What other Imagine Institute programs have you participated in? Please choose all that apply*

Imagine Institute trainingsCurrent or former Imagine U MentorCurrent or former Imagine U InternPREPARE for CareTrainer PathwaysCurrent or former Imagine trainerI have not participated in any Imagine Institute programsOther

Do any of the children you serve speak a different primary language from their parents OR speak a primary language OTHER than English?*

YesNo
Are any of the children and families you serve impacted by trauma or homelessness, are located in areas where adequate child care is unavailable, are from low-income families, or include children in foster care?*

YesNo

Do you have any final questions or comments you wish to share?
By submitting this request to join the Shared Services Hub, I agree to receive emails and text messages/SMS communication regarding Imagine Institute programs, services, and Shared Services news, alerts, and Member benefits.
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Shared Services Hub Application

About Shared Services