Trainer Application for One-time Training Approval

Trainer Application Eligibility Checklist

With this new process, we want to be sure you are only completing what is necessary. In order to determine if you need to apply, please review these instructions and questions.

New Training Approval

Do you have a new course that needs to be approved for KDHE hours.

YESNO

Date of Planned Training

Training Renewal

Do you have a course that has previously been approved and needs reapproved?

YESNO

Course Expiration Date

Revised Training

Have you revised an approved training that requires reapproval such as The learning objectives have been altered and/or, there is a change in the title of the training and/or, a significant change in the length of the training has been made (greater than 30 minutes in change)?

YESNO

Reason for Reapproval

Guest Speakers/Conferences

Guest Speakers/Conferences: Are you hosting a guest speaker, and their training needs approved for KDHE hours?

YESNO

Guest speakers or trainers who intend to deliver a course only one time are exempt from the application process; however, they must be hosted by an approved trainer. In this case, a designee from the hosting program or organization will complete this application. Once approved, the designee will be able to submit course approval paperwork for each presenter and training session.

If you prefer to have your training approved as an ongoing training (to be delivered more than once within a 5 year period) please use this form( insert link)

No Approval Needed at This Time

Based on your answers, you do not need to submit your training for approval now. If you have any questions, don't hesitate to get in touch with your Cape support team at kccto@ksu.edu.

Approved Trainer

Are you already an approved trainer within Cape?

YesNoNot sure

Proceed to Training Application

Because you are already an approved trainer you can submit trainings for one time approval for yourself or for those you are hosting. Please proceed to the training application, if you need help filling it out please check our resources page https://kccto.org/kdhe-approval/#resources

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.

Guest speakers or trainers who intend to deliver a course only one time are exempt from the application process; however, they must be hosted by an approved trainer. In this case, a designee from the hosting program or organization will complete this application. Once approved, the designee will be able to submit course approval paperwork for each presenter and training session.

Note: This application is for one trainer only and cannot be submitted on behalf of multiple trainers. Each trainer must submit a separate application.

Trainer Agreement

Click here to review the Trainer Agreement.

Contact Information

Will you be the one presenting the training

YesNo

Presenter Information

Legal First Name

Legal Last Name

Trainer/Host Information

Legal First Name

Legal Last Name

Pronouns

He/HimShe/HerThey/ThemHe/TheyShe/TheyNot ListedPrefer Not to Answer

Alternate Name/Nickname

Enter other names or nicknames you've used.

Email

Primary Phone Number

Alternate Phone Number

Training Relationship

Is this event hosted by an independent trainer or an organization?

Independent TrainerOrganizationA separate application must be completed for each training relationship.

As an independent trainer, you’ll need to provide an organization name to link this training event to your trainer profile. This could be your small business name, or if you're training/hosting on a voluntary basis, it can be any name you choose. This is how this training will be associated with you.

Organization Name

Organization Designee

Please provide the contact information for someone at your organization who can verify that you have permission to deliver training content/host guest trainers affiliated with their program. Note: the organization designee could be you or an alternate contact at your organization.

Organization Name

Organization Designee Name

Organization Designee Phone

Organization Designee Email

Trainer Profile Information

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

Yes

Are you at least 18 years of age?

YesNo

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

YesNo

Become a Trainer

Education

Education (select any or all that apply)

High School Diploma or EquivalentSome post-secondary (college or technical college) credits1-year certificateAssociates (2-year degree) Bachelors (4-year degree)Master's degree Doctorate

Total College Credits in Early Childhood Education or related field

Area of Concentration

Major(s)

Credentials/Licenses (select any or all that apply)

Child Development Associate (CDA)Kansas Director CredentialNational Director CredentialOther

Other (Specify)

Relevant Work Experience

Do you have at least 5,000 hrs. of work experience that relevant to the content you intend to train?

YesNo

Note: 2080 hours = 1 year full-time employment; 4160 = 2 years of full-time employment; 5000 hours = 2.4 years of full-time employment.

Relevant Work Experience includes both paid and unpaid work. Unpaid work includes volunteer work, internships, and other unpaid roles, as long as the experience is relevant to the training topics you plan to deliver to the Early Childhood Care and Education (ECCE) Workforce.

Relevant Professional Development

Note: Professional Development is an experience designed to help you develop new skills and stay current on trends within your area(s) of expertise. Some examples could include workshops, seminars, certification or credentialing programs, webinars, online courses, professional conferences, professional learning communities, coaching or collaborative planning sessions, and mandatory training as part of employment.

How many hours of Professional Development have you completed within your field of study in the last year?

None1 hrs. to 9 hrs.10 hrs.to 19 hrs.20 hrs. or more

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.