www.muskie.usm.maine.edu/maineroads PLEASE READ BEFORE COMPLETING APPLICATION FORM Maine Roads Scholarship Program CDA Information 2015-2016 I. DEFINITION ki i The Maine Roads Scholarship Program is a financial incentive to support those employed in the child care and early education field in Maine who are pursuing a CDA (Child Development Associate) or a college degree in early childhood education or related field. Related fields of study include Child Development, Social Work with a concentration in Early Childhood, Child Care Administration and Leadership, and Children with Special Needs. Eligible courses of study are available at many accredited colleges, universities, technical colleges and distance learning programs throughout the state of Maine. Scholarships are awarded annually through a competitive basis, as funds are available. II. ELIGIBILITY To be eligible for a scholarship, all applicants must: Be a Maine resident. Work in Maine in a licensed or certified child care and early education program. Your current worksite must be enrolled with Quality for ME. FMI: http://www.maine.gov/dhhs/ocfs/ec/occhs/qualityforme.htm Plan to use the CDA to pursue a career in the early care and education field in the State of Maine. (Examples: direct care, administration, family child care, Head Start, nursery school, school age care). Those pursuing careers with young children outside the early care and education field are not eligible for this scholarship program. (Examples: Teachers in K-8, Social Workers for the Dept. of Health and Human Services, and Pediatric Nurses in hospitals. Included but not limited to these examples.) Have a total family income that does not exceed 300% poverty level as defined by the 2014 Federal Income Guidelines. If enrolled in college half time or more (2 courses / 6 credit hours in any semester during the academic year), apply for Financial Aid through FAFSA. Be a member of the Maine Roads to Quality Registry. Students using Maine Roads Core Knowledge Trainings for the CDA must: Have completed 90 hours of Maine Roads training to meet the CDA credential requirement of 120 hours of training in core curriculum areas at time of scholarship application. Students who are enrolled in a course of study other than Maine Roads Core Knowledge Training (ex: at a community college) must: Students must be accepted for enrollment in an eligible program of study at an institution of higher education or in a CDA preparation program that has an articulation agreement with one or more institutions of higher education in Maine. A copy of their acceptance letter to an early childhood education program (or related field of study) from the college/university/cda preparation program they are attending must be provided as part of the application. Meet all CDA eligibility requirements of the Council for Early Childhood Professional Recognition to be considered for a scholarship for the CDA assessment fee. III. APPLICATION DEADLINES AND AWARD SELECTION Scholarship Application Deadline: Application Deadline: November 1, 2015 to be completed by 08/30/2016 Scholarship applicants are notified of their status by email. A copy of the award letter and a request for an itemized bill for coursework is sent to the recipient s college or training site. Upon receipt of an itemized bill from the college or training site, payment is forwarded to the college or training site on behalf of the student. We do not reimburse the student or the student s worksite directly. The amount of money awarded is for 1/2016-8/2016 and the course of study indicated on the application form. Scholarship funds not used by the recipient will be returned to the Maine Roads Scholarship fund.
Child Development Associate CDA Scholarship: For applicants pursuing a CDA, scholarship for coursework is awarded only for credit bearing courses of study. The level of scholarship is for up to $300 per course ($100 per credit hour) with a maximum of up to $900 / 3 courses per year. Or, if a student is applying for the CDA Assessment fee during the same academic year, a maximum of 2 courses ($600) and the $425 to cover the CDA Assessment fee or a maximum of $1025. Scholarship is available to cover the cost of the $425 CDA Assessment fee to those pursuing the CDA credential and indicating that they will be ready to submit their application to the Council for Early Childhood Professional Recognition in Washington D.C. The $425 CDA Assessment fee check will be made out to the Council for Early Childhood Professional Recognition and will be mailed to the student to enclose with their final application. IV. TO APPLY Fill out the enclosed application form and attach all requested documentation. You may want to make a copy of your application to keep for your records. Mail the completed Maine Roads Scholarship application and all requested documentation to: Muskie School of Public Service, Maine Roads to Quality, 12 East Chestnut Street, Augusta, Maine 04330 Fax: 626-5024 Application Deadline: November 1, 2015 for completion of CDA by 08/30/2016 All required information and documents must be provided. Please note that since awards are competitive and are available based on funding availability, incomplete and/or late applications may be denied. Please enclose: A completed application form A letter of acceptance/enrollment from your CDA training site A goal statement answering the two questions stated in Section 7 Summary and official documentation of special circumstances, if applicable A copy of your income documentation, as outlined in Section 4 A copy of your bill for the upcoming semester (thereafter must send a bill for the next semester) A completed MRTQ Registry application form and $10 application fee if you are not already a Registry member. Questions? Call Maine Roads Scholarship Program, Pam Soucy: 626-5258 The Maine Roads Scholarship Program is funded by the Maine Department of Health and Human Services, Office of Child and Family Services, Early Childhood Division
ki SECTION 1 ABOUT YOURSELF i Maine Roads CDA Scholarship Application 2015-2016 Name: Home Address: City: State: Zip: County: Home Telephone: Home Email: Date of Birth: Social Security # (last 5 digits):_ - Total Number of all Members in Household: Please List All Household Members: Household Member Name Relationship to You Age SECTION 2 CHILD CARE AND EARLY EDUCATION WORK EXPERIENCE Please use the spaces below to list your total years of experience working in child care, early education, and early intervention programs. Include all paid experience. You may include supervised experiences such as practicum or volunteer work, but please include a letter from your volunteer / practicum site indicating the number of volunteer / practicum hours you complete per month. Do not include babysitting, occasional volunteer work, scouts, parenting etc. Please list employment history starting with your current position: Agency or Program Position Held From (date) To (date) # of Years Total number of years including current position: Current Agency/Program: Phone: Fax: Worksite: Phone: Fax: (If Different than Agency/Program) Agency E-Mail: Address: City: State: Zip: Is your current Agency/Program a member of Quality for ME? Yes: No: Please indicate the groups with whom you specifically work. (Check all that apply) Infant (6 weeks to 12 months) Toddler (12 months 30 months) Preschool (30 months to kindergarten) Kindergarten School Age (7-9 years) School Age (10-12 years) School Age (13-15 years) Families
SECTION 3 EDUCATIONAL PROGRAM CDA Applicants: Maine Roads Core Knowledge Training Applicants pursuing a CDA who are enrolled in Maine Roads Core Knowledge Training and have completed at least 90 of the total 120 required hours should complete this section: Core Knowledge Training Date Completed # of Hours CDA Applicants: Other Program of Study Total # of Hours: Applicants pursuing a CDA who are enrolled in a credit bearing course of study other than the MRTQ Core Knowledge Training Program (i.e. at a community college) should complete this section: College/CDA Training Site: Address: City: State: Zip: Phone Number: Email: College/CDA Training Site Contact Person: Name Phone: Email:. Please enclose a copy of your letter of acceptance/enrollment form from your college or CDA Training Site CDA Assessment Fee Applicants Applicants who will be submitting their CDA Application to the Council for Early Childhood Professional Recognition should complete this section: I will be submitting my CDA Application to the Council for Early Childhood Professional Recognition for the following date: / Month Year SECTION 4 INCOME VERIFICATION Do you own a child care business? Yes No If you own a child care business, please enclose your family s most recent signed Federal Income Tax Forms, including documentation of your business income and expenses. If you are employed and are required to file a Federal Income Tax Form, please enclose your family s 2014 Federal Income Tax Forms which indicates total adjusted gross income and family size. If you did not have to file a Federal Income Tax Form, please enclose documented proof of your total income for 2014 such as TANF funds, child support, unemployment funds, workman s compensation, pay stubs, etc.
SECTION 5 SPECIAL CIRCUMSTANCES Sometimes there are circumstances that affect an applicant s financial ability to attend/return to school, such as a change in family income, illness or disability, etc. If you have circumstances that impact your financial ability to attend school, which you would like the Award Committee to consider when reviewing your request for scholarship, please summarize your situation and enclose official documentation of those circumstances. SECTION 6 FINANCIAL ASSISTANCE / EMPLOYER SPONSORED ASSISTANCE Applicants must list any other financial assistance/scholarships for which they have applied and the amount they have received for 2015-2016. All Sources of CDA Financial Assistance (including Financial Aid) for 2015-2016: Amount received: SECTION 7 GOAL STATEMENT Please respond to the following questions using a separate sheet of paper. Goal statement must be a minimum of 250 words. The Goal Statement must be typed, handwritten responses will not be accepted. 1. After completing my degree/certification, I plan to work directly with children by 2. Earning my degree/certification will impact my work in child care/early intervention by SECTION 8 SIGNATURE I certify under penalty of perjury that to the best of my knowledge the enclosed information is correct. I understand that the information provided will be reviewed by the members of the Maine Roads Scholarship Award Committee, by the Muskie School of Public Service and my training site/agency for use in administering this grant program. Printed Name: Signature: Date: SECTION 9 CHECKLIST Please use the checklist below to make sure you have attached all supporting documentation with your application. CHECKLIST Child Development Associate/CDA Application Application Deadline: November 1, 2015 for completion of CDA by 08/30/2016 All required information and documents must be provided. Incomplete applications may be denied. Please enclose: A completed application form A letter of acceptance/enrollment from your CDA training site, if applicable Summary and official documentation of special circumstances, if applicable. A copy of your income documentation, as outlined in Section 4. A copy of your bill for the upcoming semester (thereafter must send a bill for the next semester) A goal statement answering the two questions stated in Section 7. A completed MRTQ Registry application form and $10 application fee if you are not already a Registry member. Mail completed application and supporting documentation to: Muskie School of Public Service, Maine Roads to Quality, 12 East Chestnut Street, Augusta, ME 04330 Questions? Need more information? Call Pam Soucy: 626-5258 or email: psoucy@usm.maine.edu Fax: 626-5024