English Navigator Interest Form

Survey of Interest

Higher Education and Workforce Development NavigatorOpportunities to Earn Early Childhood Education Credentials and Degrees
Thinking about college and pursuing a credential or degree in early childhood education? Higher Education & Workforce Development Navigators are available to guide you every step of the way.

If you would like to be connected to a Higher Education Navigator who can walk you through the available opportunities, please complete the following survey and return via email to Illinois Action for Children navigators@actforchildren.org.
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email Address*
example@example.com
What is the primary language you use at home?
Gateways Register #:*
A Gateways to Opportunity Registry Member Number is needed to be considered for the scholarship. To get your Gateways Register number, visit https://registry.ilgateways.com/
Have you ever worked in a home- or center-based early care and education (ECE) program? (e.g., child care, preschool, family child care, Head Start) (Check one)

Yes, I am currently working in an ECE programYes, I previously worked in an ECE programNo, I have never worked in an ECE program
If yes, please provide the program type (check one):

Licensed Child Care CenterLicensed Family Child CareLicensed Exempt Child Care CenterLicensed Exempt Family Child CareOther
If other, please specify
Are you currently enrolled in or admitted to a college or university?

YesNo
If yes, what institution are you currently attending?
If yes, what degree are you pursuing?
What is the highest level of education, license, and/or certificate you have completed? (check one)

HS Diploma or GEDAssociates DegreeBachelors DegreeMasters DegreeProfessional Educator LicenseOther
Other degree completed
Do you currently hold or are working towards Gateways Credential? If yes, which one(s)
Do you currently hold or are working towards a CDA Credential? If yes, which one(s)
Would you be interested in receiving a scholarship and financial support for your enrollment in an early childhood education program?

YesNo
If yes, please provide the semester (i.e., Summer 2026) for which you would like to apply for an award:
What areas of professional development are you most interested in related to your work in early childhood education? Please list any topics, skills, or training you'd like to explore:
Thank you!
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Survey of Interest

Thank you!