Tennessee Early Childhood Training Alliance

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1 March 25, 2016 Tennessee Early Childhood Training Alliance 737 Union Avenue, E-105 Memphis, TN (901) fax: (901) Dear TECTA Scholarship Recipient, I hope you are enjoying the spring! It is time to register for classes and submit scholarship applications for the summer and fall 2016 semester. We are committed to providing as much tuition assistance as possible to students but funds are limited! For the summer semester, TECTA will provide tuition assistance for two courses toward the CDA Credential. Funds are available for one course toward early childhood associate and bachelor degrees. Please make sure you include a working address on your application so we can communicate with you. TECTA funds are limited so if you plan to take a course and receive tuition assistance you need to register, submit the enclosed applications, and pay the student portion prior May 13, Those who register after May 13 may not receive funding. A few things to remember: Funds are available on a first come first serve basis. Please register and pay your fees early to ensure funds are available. Your must submit all of the items listed on the enclosed checklist for your application to be considered. You must register and pay your portion of the fees before TECTA funds can be attributed (funds are not guaranteed until you pay your portion and funds are placed on your account). In order for TECTA to have time to award a scholarship for a course at Southwest, your fees are due by o by 3:30 on May 13 th for early registration o by 3:00 on the day of registration during regular registration if funds are still available Students cannot receive a refund from Federal Financial Aid and TECTA. We strongly recommend that all students apply for federal financial aid or other scholarships. You can apply for federal financial aid online at You can obtain more information about financial aid and other scholarships available at Southwest online at We know many of you have worked hard over the past few years and are very close to completing your degrees. We are pleased to still be able to offer some tuition assistance. We thank you for letting TECTA be a part of your educational journey! Please let us know as you achieve your goals. If you have any questions, feel free to call me at We look forward to seeing you soon! Sincerely, Elizabeth O. Wilson, MS TECTA Southwest Director 737 Union Avenue Memphis, TN (901)

2 Tennessee Early Childhood Training Alliance 737 Union Avenue, E-105 Memphis, TN (901) fax: (901) TECTA Tuition Assistance Check List for Degree Seeking Students Completed Application for Academic Financial Support Student Information Form Student Request to Share Information Copy of your Summer 2016 course schedule Printout showing current major/program of study Copy of check stub as proof of employment in a licensed early childhood program Grades for the last semester you attended classes Please note that all boxes must be checked and materials attached for your application to be processed. Incomplete applications will not be processed! Tuition Payment Information: For students attending Southwest: You may pick up your payment voucher in the TECTA office or call the office ( ) and request it be mailed to you. TECTA cannot make a scholarship payment until you turn in a copy of your most recent grades and pay the student portion of your fees. To ensure that TECTA has time to make a scholarship payment, the student portion is due: by 3:30 pm on May 13, 2016 for early registration by 3:00 pm on the day of registration during regular registration if funds are still available. Students are not eligible to receive a refund from federal financial aid and TECTA. If you receive federal financial aid your TECTA award amount may be adjusted. For students attending somewhere other than Southwest: TECTA can provide assistance with one BA level course. The TECTA office requires two weeks to process your application and create a payment voucher. Vouchers cannot be given without a copy of your grades from the last semester you took courses. You will be called at your home number when the voucher is ready for pick up. You may call to check on the status of your voucher. Students are not eligible to receive a refund from federal financial aid and TECTA. If you receive federal financial aid your TECTA award amount may be adjusted. * Funds are limited this year and are available on a first come first serve basis. TECTA cannot make a payment or guarantee funds availability until you register for your course and pay the student portion of your fees. This checklist and all needed documents may be faxed to or brought to the TECTA office. Student Signature

3 Tennessee Early Childhood Training Alliance (TECTA) Application for Academic Financial Support Tennessee Early Childhood Training Alliance P O Box 780 Memphis, TN College/University Semester Year Textbook Only Course Name Subject Course Number Section Name: Last First Middle Social Security Number - - Gender: Male Female Citizenship: United States Other DOB / / Ethnicity: Hispanic Non -Hispanic Race: Asian Pacific Island Black Native American Indian/Alaska Native Other Two or more races White Address City State Zip Home County Home Phone ( ) Cell Phone ( ) Emergency Contact Person Phone ( ) Academic degree program this semester: Choose One CDA Prep CDA Renewal Technical Certificate Administrator Credential Associate Degree Bachelor Degree Graduate Degree Desired Major Early Childhood Education Elementary Education PreK Other Graduation Information I will graduate this semester yes no Place of Employment Work County Work Address City State Zip Name of Director: Last First Phone ( ) Fax ( ) Eligibility Phone : (901) In order to qualify for continued TECTA support, the student must provide a transcript showing that he/she completed and passed the previous course(s) for which he/she received financial support from the TECTA program. NOTICE: If you have changed your name and/or address since you last enrolled in a TECTA-sponsored course, please fill out a Change of Name/Address form and return it as soon as possible to the local TECTA site. I understand that I am enrolling in an academic course and will be responsible for completing the class. Failure to complete all information on this form will result in your application not being processed. If for any reason I cannot finish the course, I will submit notice to the TECTA office in writing immediately, return textbook, and agree to pay the entire tuition fee for re-enrollment in a TECTA class. In addition, I grant TECTA permission to access my academic record. Signature Date This project is funded through a contract with the Tennessee Department of Human Services and Tennessee State University, Center of Excellence for Learning Sciences. TSU-TECTA Center of Excellence for Learning Sciences Revised 12/17/2013 Tennessee State University Form: TECTA Tuition Assistance Request

4 Tennessee Early Childhood Training Alliance (TECTA) Student Information Form P O Box 780 Memphis, TN Phone : (901) PLEASE PRINT CLEARLY. Semester Year TECTA Orientation Location or Institution Attending Social Security Number: - - Name: Last First Middle Employment History Ages of children in classroom (choose one) Birth to 8 months 9 to 17 months 18 to 36 months Ages 3 5 School Age Mixed Age Group Infants Mixed age group Infant & Preschool Family Childcare Please note this question is for research purposes ONLY. Individual responses will not be identified and published. Salary $ per Hour day week bi-weekly month year Current Position Title: Asst. Director Asst. Director/Teacher Caregiver/Teacher Director Director/Teacher Other Owner of Program Sub/Floater Asst. Teacher Volunteer Number of years in current position Number years in Early Childhood Field. Number of years at current place of employment: Hrs worked per week: Do you have children with diagnosed delays or disabilities in your classroom? yes No Number of Children in classroom Please check the professional organization(s) to which you belong: Head Start Association National Association for the Education of Young Children National Black Child Development Institute National Child Care Association National Family Child Care Association Tennessee Association for the Education of Young Children Tennessee Family Child Care Alliance Tennessee School-Age Care Alliance Center of Excellence for Learning Sciences Revised 12/16/2013 Tennessee State University TSU-TECTA Form: TECTA Student Information

5 Complete this portion only the first time you receive TECTA services Highest educational achievements before seeking TECTA support < 9 th grade 9 th 12 th grade (no diploma) High School Graduate/GED some college Technical certificate Associate Applied Science Associate Baccalaureate Masters/Doctorate College or university of highest degree Major: Early Childhood Education Elementary Education Special Education Other Graduation Date / Parents Educational Levels: Mother < 9 th grade 9 th 12 th grade (no diploma) High School Graduate/GED some college certificate Associate Baccalaureate Masters/Doctorate Father < 9 th grade 9 th 12 th grade (no diploma) High School Graduate/GED ome college certificate Associate Baccalaureate Masters/Doctorate Professional Objectives Why do you want to participate in TECTA training? (Check all that apply): Further my education Help with my job search Improve my job skills Obtain CDA Obtain raise I have completed other early childhood training during the last 12 months Yes No Was the training required by your employer? Yes No Do you plan to continue working in child care? Yes No If no, please tell why NOTICE: If you have changed your name and/or address since you last enrolled in a TECTA-sponsored course, please fill out a Change of Name/Address form and return it as soon as possible to the local TECTA site. Center of Excellence for Learning Sciences Revised 12/16/2013 Tennessee State University TSU-TECTA Form: TECTA Student Information

6 Student Request to Share Information Office of Admission and Records Name of institution where student is enrolled Student s Name (Please Print) Last First Middle Initial SS# Address: Street City State Zip Code Phone: ( ) Semester: Year: I know that the Family Educational Rights and Privacy Act of 1974, as amended (FERPA), protects the privacy of my student educational records and limits access to the information contained in those records. Because I receive financial support covering all or part of my tuition from the TSU-TECTA program, I am hereby authorizing the Southwest Tennessee Community College Office of Admission and Records to release my grades and academic status information to the local TECTA Site Director for transmission to the TSU-TECTA Management Office. The information will be used to determine and verify my eligibility for continued TSU- TECTA financial support and will be protected in accordance with the provisions FERPA. My grade and academic status information should be sent to: Name: Address: _Elizabeth O. Wilson, Southwest -TECTA Director P.O. Box 780 Memphis, TN (901) Student s Signature Date

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