HCE Childcare Capacity Teacher Journey
Teacher Information
Provider photo
*
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Name
*
First Name
Last Name
What sex are you?
*
Female
Male
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Mailing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
County
*
Please Select
Clackamas
Multnomah
Washington
Other
Other
What race/ethnicity best describes you?
*
African
Africa American
Alaska Native,
American Native
Asian
Latina/Latino
Native Hawaiian or Other Pacific Islander
White
Prefer not to answer
Are you working with any other organization?
*
Right From the Start (RFTS)
Micro Enterprise Services of Oregon (MESO)
Neighborhood House
Not currently working with any other organization
Other
Other
Do you have a current Childcare Background Registry number with DELC?
*
Please Select
Yes
No
Central Background Check Number (CBR Number)
*
Please put N/A if you currently do not have a CBR number. A CBR number is required to participate in our grants and pathways.
CBR approval letter
*
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What childcare setting are you open to working?
*
In-home program
Head Start
Commercial Private Childcare program
Open to different settings.
What county would you like to work?
*
Multnomah
Washington
Clackamas
Other
If other,
Do your program participate in any subsidized programs?
*
Employment Related Daycare Cost (ERDC)
Preschool Promise (PSP)
Preschool for All (PFA)
Baby Promise
Inclusive partners
None
Are you currently employed at a licensed childcare program?
Yes
No
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Tell us about how you work in the Early Childhood Education field
Name of Childcare or Organization you work for
*
Input N/A if you are new to the field and do not currently provide care put N/A
License number
Website
Address of work location
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What is your current Step in Oregon Registry Online (ORO)?
*
Please Select
I have never heard about Steps.
I have heard about Steps, but I do not have any Steps in ORO.
1
2
3
4
5
6
7
8
9
10
11
12
What step would you like to obtain in the next six months?
*
Please Select
1
2
3
4
5
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7
8
9
10
11
12
Please upload your professional development statement from your Oregon Registry Online (ORO).
*
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