Start Your Career in Childcare! Taking Root Application Form Your answers will determine your eligibility and will be kept strictly confidential. Name* First Last Address* Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Phone*If you do not have a phone number, please indicate how we can contact you. Email*If you don't have an email, please write N/A. Are you employed?* No Casual Part-time Full-time If yes, how many hours per week do you work (estimate)?* If yes, where do you work and what is your job?*What are your long term employment goals?*Why are you interested in taking the Taking Root Childminding Training?*What is the highest level of schooling you have finished?* Some middle school Completed grade 9 Completed grade 10 Completed grade 11 Completed high school (grade 12) GED/ High School Equivalency Completed some post-secondary courses College diploma/certificate Trades/ technology/ apprenticeship University degree Graduate school If English is not your first language, what is your Canadian Language Benchmark level for SPEAKING? Benchmark 1 Benchmark 2 Benchmark 3 Benchmark 4 Benchmark 5 Benchmark 6 Benchmark 7 Benchmark 8 Benchmark 9 Benchmark 10 If English is not your first language, what is your Canadian Language Benchmark level for LISTENING? Benchmark 1 Benchmark 2 Benchmark 3 Benchmark 4 Benchmark 5 Benchmark 6 Benchmark 7 Benchmark 8 Benchmark 9 Benchmark 10 Do you have children? Yes No Please select all age groups that apply for your children: 0-5 years old 6-11 years old 12-18 years old 18 years and older Are you available to attend all 16 sessions (Tuesday and Thursday afternoons) in July & August?* Yes No If no, please explain how many sessions you expect to miss and why.*Upload your resume if you have one.Max. file size: 64 MB.