Directors Institute - Babies, Tots & Play - April 21, 2023

Personal Information

• * First Name:
• * Last Name:
• * Phone:
• * Email Address:
• * Confirm Email Address:

• Type of Program

  • Center-based
  • Home-based
• Number of children age birth to 36 months with whom you work:
• *

  Position

  • Teacher/Caregiver
  • Director
  • Other

• Fee

  Type	Fee
  Non - VQB5 Partners	$30.00
  Scholarship	No Charge
  VQB5 Partners	$20.00

Business Information

• * Company:
• * Address 1:
• * City:
• * State: --Choose-- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming -------------- Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Territory
• * ZIP Code:

• Is your Day Care/Child Care Center enrolled in VQB5?

  • Yes
  • No

Lunch is included. Please indicate preference

• Lunch Options

  • Standard Lunch
  • Vegetarian Lunch
  • Special Dietary Requirements
• Special Dietary Requirements:

• Registration and payment must be received one week prior to training. A non-refundable registration fee is required to reserve your space. No Refunds-substitutes only.

• You may pay the registration fee with a credit card by clicking CONTINUE below, or call Bertie B. at (757) 378-3168 with the information. If paying by check, it must be received one week prior to the event date. Please write the location of your training on the memo line, and include a list of registrants. Mail to: Child Development Resources, PO Box 280, Norge, VA 23127