Trainer Application

Information

Thank you for your interest in becoming a approved trainer in Kansas. This is the first step in having training approved for in-service hours for professionals working in child care settings.

We value the trust you place in us when you submit your application. Please be assured that all applications and their contents will be reviewed with the utmost confidentiality, professionalism, and sensitivity. We aim to ensure a fair and respectful evaluation process for all applicants.

Eligible applicants will review the trainer agreement, be a minimum of 18 years of age, and have earned a high school diploma or equivalent. If you do not meet those requirements, please exit the application.

Eligibility

I have reviewed and understand the Trainer Agreement. Trainers who are approved will be required to sign a trainer agreement on an annual basis.

YesNo

Are you at least 18 years of age?

YesNo

Do you have at least a high school diploma or equivalent?

YesNo

Contact Information

Legal First Name

Legal Last Name

Alternate Name/Nickname

Enter other names or nicknames you've used.

Email

Primary Phone Number

Alternate Phone Number

Affiliation

Will you be conducting training as an independent trainer or on behalf of an organization?

Independent TrainerOrganization

Organization Designee

Upon approval as a trainer, the organization designee will be contacted to register the organization and/or verify your affiliation. Please provide contact information for an individual at the organization who can provide demographic details about the organization, such as number of employees, average salary, and filing status.

Organization Name

Organization Designee Name

Organization Designee Phone

Organization Designee Email

Trainer Directory

The statewide trainer directory will be a feature within Cape to allow users to search for trainers by region, training format, languages, and specializations. This section is optional. Your responses to these questions do not impact the outcome of your trainer application.

Would you like to opt in to the Statewide Trainer Directory

YesNo

Trainer Modalities

Live VirtualIn-personOnlineHybrid

Kansas Counties to serve in-person (Hold down the control (ctrl) key to select multiple counties, if applicable)

Will the trainings you offer have a cost associated?

YesNoVaries

Agreement

I hereby certify that all information provided in this application is true, complete, and accurate to the best of my knowledge. I understand that any false statements or omissions may result in disqualification from the application process or termination of agreement if discovered at a later date.

Signature

Your typed legal first and last name will serve as your signature.

Contact Information