3. Request official transcript(s), if appropriate, be sent directly from the university/college to the Credential Office using the enclosed form(s).



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Colorado Department of Human Services (CDHS) Colorado Early Childhood Professional Credential Office School Age/Youth Credential Application Directions: 1. Complete pages 2, 3, 4 and 5 of the application and the page(s) which correspond to the Credential for which you are applying. Credential Overview Page 6 Level I Page 7 Level II Page 8 Level III Pages 9 and 10 Level IV Pages 11 and 12 Level V Page 13 Level VI Page 14 Conversion of Experience Chart Page 15 Transcript request form Page 16 2. Compile supporting documentation. As specified in the application, supporting documentation may include the following: Copy of letter(s) on business stationary from a current or past employer(s) stating the amount of time worked and the dates worked; A copy of the Colorado Department of Human Services family child care license indicating number of years in operation; Copy(s) of certificates/credentials such as a Child Development Associate, Certified Child Care Professional, etc. (see application for entire list); Letter/certificate from instructor stating completion of non-credit college training approved by the Colorado Department of Human Services or the Colorado Early Childhood Professional Credential Office; A copy of the Colorado Department of Human Services letter stating that director qualifications for a large child care center have been met. 3. Request official transcript(s), if appropriate, be sent directly from the university/college to the Credential Office using the enclosed form(s). 4. Cost: Processing fee has been waived. 5. Send the completed application and documentation to: Colorado Early Childhood Professional Credential Office 3607 Martin Luther King Blvd Denver, CO 80205 (303) 333-6017 Thank you for your interest in attaining a School Age-Youth Professional Credential and for the work you do on behalf of children and youth. 1

Colorado Department of Human Services (CDHS) Colorado School Age- Youth Professional Credential Application Please complete the following: First Name MI Last Name List Other Names Used (maiden name, previous married names) Social Security Number Home Address Number Street City County State Zip Code Home Phone ( ) Work Phone ( ) Fax Number ( ) E-mail Address ( ) Date of Birth Month Day Year Gender [1] Female [2] Male Ethnicity: [1] African American/Black [4] Asian/Asian American [2] Hispanic/Latino(a) [5] White Non-Hispanic/Anglo [3] Native American/American Indian [6] Other Bilingual: [1] Yes [2] No Primary (1 st ) Language: [1] English [2] Spanish [3] Other Other Languages spoken: [1] English [2] Spanish [3] Other 2

EMPLOYMENT INFORMATION This information will help determine the impact of the credentialing system within the school age/youth development field. Your specific information will not be made public. 1. Years in the field of school age/ youth development, including both direct and indirect services: [1] less than 6 months [2] 6-12 months [3] 1-2 years [4] 3-5 years [5] 6-10 years [6] more than 10 years 2 a. Check one which most closely defines your current position: [1] Licensed family child care provider [2] Family child care provider legally exempt from licensing [3] Experienced Family Child Care Provider [4] Aide in a Head Start program [5] Teacher in a Head Start program [6] Montessori teacher [7] Educational Specialist in a Head Start program [8] Director in a Head Start program [9] Family Outreach Worker in a Head Start Program [10] Aide in an early childhood, school age/youth program [11] Teacher/Group Leader in an early childhood, school age/youth program or infant/toddler [12] Assistant Director of an early childhood or school age/youth program [13] Director of an early childhood or school age/youth program [14] Infant Nursery Supervisor [15] Public school teacher [16] Nanny [17] Parent Educator/Support Provider [18] Early Childhood Instructor/Trainer [19] Child Care Resource and Referral Specialist [20] Mentor [21] Other 2 b. [1] Current hourly wage: OR [2] Current Annual Salary 3

2 c. Other position(s) currently held, please check all that apply: [1] Licensed family child care provider [2] Family child care provider legally exempt from licensing [3] Experienced Family Child Care Provider [4] Aide in a Head Start program [5] Teacher in a Head Start program [6] Montessori teacher [7] Educational Specialist in a Head Start program [8] Director in a Head Start program [9] Family Outreach Worker in a Head Start Program [10] Aide in an early childhood, school age/youth development program [11] Teacher/Group Leader in an early childhood, school age/youth development program [12] Assistant Director of an early childhood or school age/ youth development program [13] Director of an early childhood or school age/youth program [14] Infant Nursery Supervisor [15] Public school teacher [16] Nanny [17] Parent Educator/Support Provider [18] Early Childhood/ School Age Instructor/Trainer [19] Child Care Resource and Referral Specialist [20] Mentor [21] Other 2 d. Do you hold a paying position outside of the school age/youth development field? [1] Yes [2] No 3. Does your employer provide incentives for you to get advanced training/education? [1] Yes [2] No [3] Don t know 4. If yes, please check all that apply: [1] One time cash bonus [4] Scholarship funds [7] Don t know [2] Wage increase [5] Release time [8] Other [3] Book allowance [6] Transportation allowance 5. Name of current agency where employed (Examples: RRCC SACC, Logan Public Schools, Boys and Girls Club) 4. If applicable, name of program/center where currently employed: (Examples of education program/center: Jessie Whaley Maxwell Elementary, RubyPark Child Care) 7. Address of current education program/center Number Street City County State Zip Code 4

8. If applicable, name of classroom (Examples: Frogs, Extended Day, Stars) 9. If applicable, Colorado Department Human Services child care license number 10. Check all that apply: [1] Part Day Program [3] Part Year Program [2] Full Day Program [4] Full Year Program 11. How long have you worked with this program? [1] less than 6 months [2] 6-12 months [3] 1-2 years [4] 3-5 years [5] 6-10 years [6] more than 10 years 12. Ages of children served in or by this program; please check all that apply: [1] Infants (6 weeks - 1 year of age) [2] Toddlers (1-2 ½ years of age) [3] Preschoolers (2 ½ - 5 years of age) [4] Kindergarten (5 6 years of age) [5] School-age/youth (5 18 years of age) 13. Ages of children with whom you work directly, please check all that apply: [1] Infants (6 weeks - 1 year of age) [2] Toddlers (1-2 ½ years of age) [3] Preschoolers (2 ½ - 5 years of age) [4] Kindergarten (5 6 years of age) [5] School-age/youth (5 18 years of age) [6] not applicable I am applying for Colorado School Age/Youth Professional Credential Level Date: Signature: 5

Credential Levels Credential Overview Education Experience Length of Credential Renewal Level I Training and/or course work which covers the Level 1 Standards, a minimum of 90 clock hours 3 months (480 hours) Valid for 3 years 3 semester credit hours Renewable twice Level II Training and/or course work which covers the Level 1 & Level 2 Standards, a minimum of 270 clock hours 2 years (4,000 hours) Valid for 5 years 6 semester credit hours Renewable Level III Associate Degree 1 year (2,000 hours) Level IV Baccalaureate Degree 1 year (2,000 hours) Level V Masters Degree 2 years (4,000 hours) Level VI Doctoral Degree 2 years (4,000 hours) Valid for 5 years Valid for 5 years Valid for 5 years Valid for 5 years 6 semester credit hours Renewable 6 semester credit hours Renewable 6 semester credit hours or major professional contribution Renewable 6 semester credit hours or major professional contribution Renewable Please note this is an overview and does not list all of the criteria, or ways to meet those criteria, needed to meet credential standards. Credit hours within this document refers to semester credit hours from a regionally accredited college or university. Equivalent credit hours from a regionally accredited college or university will be accepted. To meet educational and renewal requirements for the Colorado School Age-Youth Professional Credentials, only credit hours from accredited colleges or universities with a C grade or better will be accepted. 6

LEVEL I CREDENTIAL Indicates completion of training which has met the Level 1 Standards as delineated in Colorado s Core Knowledge and Standards: A Guide for School Age-Youth Professional Development. This is equivalent to Colorado Community Colleges School Age Theory and Practice and School Age Practicum. 1. Age Must be 18 years of age or older and REQUIREMENTS 2. Experience Documentation of 480 hours experience in a school age or youth program and 3. Education - The educational requirements can be met in one of the following ways: Please Check All That Apply A. 6 semester credits from a regionally accredited college or university in school age education or youth services or B. One of the school age or youth development certificates/credentials listed below or C. 80% competency on the challenge test to meet this educational requirement, when available. A. Semester credits, non-credit training, or combinations Six semester credits in school age or youth development from a regionally accredited college/university. Official transcripts must be mailed directly from the college or university to be considered. [1] 3 semester credits in School Age Theory and Practice and 3 semester credits in School Age Practicum Non-credit training equivalent to 90 clock hours which will be reviewed by the Colorado Department of Human Services or the Colorado Early Childhood Professional Credential Office [2] Pre-approved training covering the Basic Level Core Knowledge and Standards [3] 80% competence rate on the challenge test that covers the Level Basic Core Knowledge and Standards [4] 180 clock hours of training for Program Leader, covering Basic Level Core Standards and specific Advanced Level Core Standards which are taught in the following courses: School Age Theory and Practices, School Age Practicum, Child and Adolescent Development, Promoting Positive Mental Health in School Age Programs, Curriculum Development for School Age Programs, Working with Parents, Families, and Community Systems. B. Certificates/Credentials [3] US Army School Age Credential [4] Montessori Certificate for elementary school teacher C. An assessment certificate verifying at least an 80% competency rate on the challenge test that covers Level I Core Standards. CREDENTIAL RENEWAL 1. Before current credential expires, one of the following is required for renewal: A minimum of 3 semester credits from an accredited college or university in school age, youth, early childhood or other related fields. 2. The Level I Credential is valid for three years and is renewable twice. 7

LEVEL II CREDENTIAL Indicates completion of training which has met Level 1 and Level 2 Standards as delineated in Colorado s Core Knowledge and Standards: A Guide for School Age-Youth Professional Development. This is equivalent to Colorado Community Colleges six core school age-youth education courses, which includes School Age Theory and Practices, School Age Practicum. A. Age 19 years of age or older and REQUIREMENTS B. Experience Documentation must be provided of at least 2,000 clock hours of supervised and/or paid occupational experience in licensed school age or youth programs. Forty-five hours of school age or youth development practicum from an accredited college or university will be accepted toward the 2,000 hours. See page 16 for Conversion of Experience. Documentation for family child care providers must be a copy of the Colorado Department of Human Services license indicating number of years in operation. Must be able to provide documentation of hours worked with school age/ youth. Should not include hours with custodial children. Documentation for providers working in a center must be a signed letter(s) on business stationary from a current or past employer(s) stating dates and numbers of hours worked or Colorado Department of Human Services letter stating that director qualifications for a large child care center have been met. C. Education - The educational requirements can be met in one of the following ways: Please Check One [1] Colorado Department of Human Services letter stating that director qualifications for a large child care center have been met and 3 three semester credit courses in School Age Education or Youth Development: Child and Adolescence Development, Promoting Positive Mental Health in School Age Programs, Working with Parents, Families and Community Systems. [2] 6 three semester credit courses in School Age Education (Community College Certificate - Red Rocks Community College) or equivalent in Youth Services: School Age Theory and Practices, School Age Practicum, Child and Adolescent Development, Promoting Positive Mental Health in School Age Programs, Curriculum Development for School Age Programs, Working with Parents, Families, and Community Systems. All credited training must be from a regionally accredited college or university. Official transcripts must be mailed directly from the college or university to be considered. [3] US Army s School Age Credential and 4 three semester credit courses in School Age Education or Youth Services: Child and Adolescent Development, Promoting Positive Mental Health in School Age Programs, Curriculum Development for School Age Programs, Working with Parents, Families and Community Services. [4] Pre-approved training covering the Level I Core Knowledge and Standards and 4 three semester credit courses in School Age Education or Youth Services: Child and Adolescent Development, Promoting Positive Mental Health in School Age Programs, Curriculum Development for School Age Programs, Working with Parents, Families and Community Services. [5] At least an 80% competency rate on the challenge test that covers Level 1 and Level 2 Core Knowledge and Standards. CREDENTIAL RENEWAL 1. Before current credential expires, the following is required for renewal: A minimum of 6 semester credit hours from a regionally accredited college or university. 2. The Level II Credential is valid for five years and is renewable. 8

LEVEL III CREDENTIAL Indicates completion of an associates degree including training that meets the Level 1 and Level 2 Standards as delineated in Colorado s Core Knowledge and Standards: A Guide for School Age-Youth Professional Development. A. Age - 19 years of age or older and REQUIREMENTS B. Experience Documentation must be provided of at least 4,000 clock hours of supervised and/or paid occupational experience in licensed school age or youth programs. Forty-five hours of early childhood practicum from an accredited college or university will be accepted toward the 4,000 hours. See page 16 for Conversion of Experience. Documentation for family child care providers must be a copy of the Colorado Department of Human Services license indicating number of years in operation. Documentation for providers working in a center must be a signed letter(s) on business stationary from a current or past employer(s) stating dates and numbers of hours worked or Colorado Department of Human Services letter stating that director qualifications are met and C. Education - The educational requirements can be met in one of the following ways. Official transcripts must be mailed directly from the college or university to be considered. Please Check One [1] An associate degree from a regionally accredited college in School Age Education or Youth Services. [2] An associate degree from a Colorado Community College which includes the 6 three semester credit courses in School Age Education or Youth Services (Colorado School Age Certificate): School Age Theory and Practices, School Age Practicum, Child and Adolescent Development, Promoting Positive Mental Health in School Age Programs, Curriculum Development for School Age Programs, Working with Parents, Families and Community Services. [3] An associate degree, in a field other than school age or youth development, from a regionally accredited college and an additional 18 semester credits in: School Age Theory and Practices, School Age Practicum, Child and Adolescent Development, Promoting Positive Mental Health in School Age Programs, Curriculum Development for School Age Programs, Working with Parents, Families and Community Services. [4] An associate degree and a US Army School Age Credential and 4 three semester credit courses in School Age Education or Youth Services: Child and Adolescent Development, Promoting Positive Mental Health in School Age Programs, Curriculum Development for School Age Programs, Working with Parents, Families and Community Services. [5] An associate degree, in a field other than early childhood, from a regionally accredited college, a Colorado Department of Human Services letter stating that director qualifications for a large child care center have been met, and 3 three semester credit courses in School Age Education or Youth Services: Child and Adolescent Development, Promoting Positive Mental Health in School Age Programs, Working with Parents, Families and Community Services. [6] An associate degree, in a field other than early childhood, from a regionally accredited college and an at least an 80% competency rate on the challenge test that covers Level 1 and Level 2 Core Knowledge and Standards. 9

CREDENTIAL RENEWAL 1. Before current credential expires, the following is required for renewal: A minimum of 6 semester credit hours from a regionally accredited college or university. 2. The Level III Credential is valid for five years and is renewable. 10

LEVEL IV CREDENTIAL Indicates completion of a bachelors degree including training that meets the Level 1 and Level 2 Standards as delineated in Colorado s Core Knowledge and Standards: A Guide for School Age-Youth Professional Development. A. Age - 21 years of age or older and REQUIREMENTS B. Experience Documentation must be provided of at least 6,000 clock hours of supervised and/or paid occupational experience in licensed school age or youth programs. Forty-five hours of school age/youth practicum from an accredited college or university will be accepted toward the 6,000 hours. See page 16 for Conversion of Experience. Documentation for family child care providers must be a copy of the Colorado Department of Human Services license indicating number of years in operation. Documentation for providers working in a center must be a signed letter(s) on business stationary from a current or past employer(s) stating dates and numbers of hours worked or Colorado Department of Human Services letter stating that director qualifications for a large child care center have been met and C. Education - The educational requirements can be met in one of the following ways. Official transcripts must be mailed directly from the college or university to be considered. Please Check One [1] A Baccalaureate degree in School Age Education or Youth Services from a regionally accredited college or university. [2] A Baccalaureate degree from a regionally accredited college or university and 6 three semester credit courses in School Age Education or Youth Services (Community College School Age Certificate): School Age Theory and Practices, School Age Practicum, Child and Adolescent Development, Promoting Positive Mental Health in School Age Programs, Curriculum Development for School Age Programs, Working with Parents, Families and Community Services. [3] A Baccalaureate degree from a regionally accredited college or university and a US Army Credential and 4 three semester credit courses in School Age Education or Youth Services: Child and Adolescent Development, Promoting Positive Mental Health in School Age Programs, Curriculum Development for School Age Programs, Working with Parents, Families and Community Services. [4] A Baccalaureate degree from a regionally accredited Colorado college or university and pre-approved training covering the Level I Core Knowledge and Standards and 4 three semester credit courses in School Age Education or Youth Services: Child and Adolescent Development, Promoting Positive Mental Health in School Age Programs, Curriculum Development for School Age Programs, Working with Parents, Families and Community Services. [5] A Baccalaureate degree and Colorado Department of Human Services Director for a large child care center qualifying letter and 3 three semester credit courses in School Age Education or Youth Services: Child and Adolescent Development, Promoting Positive Mental Health in School Age Programs, Curriculum Development for School Age Programs. 11

[6] A Baccalaureate degree from a regionally accredited college or university with a teacher s license and four 3 semester credit courses in School Age Education or Youth Services: Child and Adolescent Development, Promoting Positive Mental Health in School Age Programs, Curriculum Development for School Age Programs, Working with Parents, Families and Community Services. [7] A Baccalaureate degree from a regionally accredited college or university and at least an 80% competency rate on the challenge test that covers Level 1 and Level 2 Core Standards. CREDENTIAL RENEWAL 1. Before current credential expires, one of the following is required for renewal: A minimum of 6 semester credit hours from a regionally accredited college or university or; If a valid teaching licensure is held, the on-going professional work required by the license will count for renewal. 2. The Level IV Credential is valid for five years and is renewable. 12

LEVEL V CREDENTIAL Indicates completion of a masters degree in School Age Education, Youth Development, or closely related field A. Age - 21 years of age or older and REQUIREMENTS B. Experience Documentation must be provided of at least 6,000 clock hours of supervised and/or paid occupational experience in licensed school age or youth programs. Forty-five hours of early childhood practicum from an accredited college or university will be accepted toward the 6,000 hours. See page 16 for Conversion of Experience. Fifty percent of hours can be in administration of programs. Documentation for family child care providers must be a copy of the Colorado Department of Human Services license indicating number of years in operation. Documentation for providers working in a center must be a signed letter(s) on business stationary from a current or past employer(s) stating dates and numbers of hours worked or Colorado Department of Human Services letter stating that director qualifications are met. And C. Education The educational requirements can be met in one of the following ways. Official transcripts must be mailed directly from the college or university to be considered. Please Check One [1] A Masters degree in School Age Education or Youth Services from a regionally accredited college or university. [2] A Masters degree in a related field such as Recreation, Social Work, Human Development, Education, Family Studies from a regionally accredited college or university with an emphasis in school age, adolescent studies, or youth development. CREDENTIAL RENEWAL 1. Before current credential expires, one of the following is required for renewal: A minimum of 6 semester credit hours from a regionally accredited college or university; or If a valid teaching licensure is held, the on-going professional work required by the license will count for renewal; or Documented major contribution to the School Age or Youth Services profession in one or more areas, e.g. research, publications, leadership, administration, and advocacy. 2. The Level V Credential is valid for five years and is renewable. 13

LEVEL VI CREDENTIAL Indicates completion of a doctoral degree in school age education, youth development, or closely related field. A. Age 21 years of age or older and REQUIREMENTS B. Experience Documentation must be provided of at least 6,000 clock hours of supervised and/or paid occupational experience in licensed school age or youth programs. Forty-five hours of early childhood practicum from an accredited college or university will be accepted toward the 6,000 hours. See page 16 for Conversion of Experience. Fifty percent of hours can be in administration of programs. Documentation for family child care providers must be a copy of the Colorado Department of Human Services license indicating number of years in operation. Documentation for providers working in a center must be a signed letter(s) on business stationary from a current or past employer(s) stating dates and numbers of hours worked or Colorado Department of Human Services letter stating that director qualifications for a large child center have been met and C. Education - Official transcripts must be mailed directly from the college or university to be considered. Please Check One [1] A Doctoral degree from and accredited college or university in School Age Education or Youth Services. [2] A Doctoral degree from an accredited college or university in a related field, such as Education, Social Work, Recreation, Human Development, Family Studies with an emphasis in adolescent studies or youth development and documented major contribution to the profession in one or more areas, e.g., research, public policy, administration, advocacy. CREDENTIAL RENEWAL 1. Before current credential expires, one of the following is required for renewal: A minimum of 6 semester credit hours from a regionally accredited college or university; or If a valid teaching licensure is held, the on-going professional work required by the license will count for renewal; or Documented major contribution to the school age or youth development profession in one or more areas, e.g. research, publications, leadership, administration, and advocacy. 2. The Level VI Credential is valid for five years and is renewable. 14

CONVERSION OF OCCUPATIONAL EXPERIENCE FROM HOURS INTO MONTHS = 6 months x 20 hours a week 480 hours 720 hours = 9 months x 20 hours a week 1,080 hours =9 months x 30 hours a week 1,440 hours = 9 months x 40 hours a week 2,000 hours = 1 year fulltime = 12 months x 40 hours a week = 18 months x 30 hours a week = 24 months x 20 hours a week 4,000 hours = 2 years fulltime = 24 months x 40 hours a week = 36 months x 30 hours a week = 48 months x 20 hours a week 6,000 hours = 3 years fulltime = 36 months x 40hours a week = 48 months x 30 hours a week = 60 months x 20 hours a week For More Information Contact: Colorado Early Childhood Professional Credential Office 3607 Martin Luther King Blvd Denver, CO 80205 303.333.6017 phone 303.333.6020 fax sudy.opsahl@ccd.edu 15

Transcript Request Form (Sent to College/University by Applicant) I am requesting that an official copy of my transcript be sent with this form to: Colorado Early Childhood Professional Credential Office 3607 Martin Luther King Blvd Denver, CO 80205 I attended from to Print Name of College or University mm/yy mm/yy My name used when I attended your college or university: Print: First Name MI Last Name My current name (if different from above): Print: First Name MI Last Name Social Security Number: Signature Date Please make copies of this form as needed 16