CHILD CARE OPTIONS


QUALITY IMPROVEMENT

RESOURCES


Payments for Training & CEU's

A separate form is required for each person registered for training.

First Name

Last Name

 Today's Date

    mm/dd/yy

Home Address

 

                     

City, State, Zip

   


 

Personal Email

   Personal Phone       000-000-0000

Program Name


If you are a Family Child Care provider, enter business name or "Family Child Care"

    Work Phone    000-000-0000

Class information
You must be registered for a workshop on www.OPDN.org before you can send your payment. Payment is due immediately. If payment is not received within 5 days, your registration may be cancelled.

 Please note: IACET-CEU payment (for attendees renewing CDA credential) is due upon registration. School-age trainings are not eligible for CEU's.

Title of Class

Date
mm/dd/yy

 County of Training

CEU's
If yes, then select $10

Class Cost
$8 PER HOUR of training

Total Cost

 

 

$

$

$

 

$

$

$

 

$

$

$

 

$

$

$
           

I will pay by   

Check or Money Order
Credit Card or PayPal: Enter First/Last name of card holder or         
     Business Name

Total Due  

$

Please enter this number in the field highlighted in yellow. If you do not, you will receive an error message.  

 




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