Utilize the fields below to submit experience working with infants (0-12 months), over the course of the last two years. Utilize the number of fields necessary and scroll to the bottom of the page and click next to continue.

Submit the names of classes/courses/workshops, the educator's name, and the amount of time taken to complete. A minimum of 10 hours of continued education related to newborns must be provided. Utilize the number of fields necessary and scroll to the bottom of the page and click next to continue.

By my signature below, I certify the information I provided on and in connection with this form is true and correct to the best of my knowledge. I also understand that any false statements or deliberate omissions on this form may subject my application for recertification to be denied due to fraudulent misrepresentation.