Before you complete this application, you must have attended a Program Administration Scale (PAS-3) Reliability Training and have achieved 85% or higher final reliability check within the last three months. If you have completed those requirements, the next step is to complete this application, pay the $300 application fee, and complete and submit one PAS-3 Assessment. If certified, your PAS-3 Assessor Certification is valid for five years.

Contact Information

Fill out the information below, then click Next to continue.

Address
* Is the address above your home or organization address?This question is required.

Personal Information

* Role that most closely resembles your job This question is required.
* What is the highest educational level you have completed?This question is required.
Did you major in child development or early childhood education in any of your earned degrees?

Marketing Information

* How did you hear about this learning opportunity? (select all that apply)This question is required.

Demographic Information

The McCormick Institute for Early Childhood at National Louis University collects demographic information about the individuals we serve to evaluate our programs and to examine various categories or populations of our constituents.  The information you provide may be combined (aggregated with that of others and reported to our funding organizations or other stakeholders).  The use of all information collected will comply with the policies of National Louis University and the Family Educational Rights and Privacy Act of 1974 (FERPA).  We would appreciate your providing this important information so that the McCormick Institute can best understand who we are serving and tailor our programs to meet the needs of early childhood leaders in our field.

 At the McCormick Institute, we know that words are powerful and word choices matter. We do our best to be inclusive in our language, mindful of our word choices, and sensitive to the preferences of all individuals and communities. In order to comply with our scopes of work, we have incorporated terminology used by our funders in our registration and data collection materials. If you would like to provide us feedback, please feel free to email us at McCormickInstitute@nl.edu 

* GenderThis question is required.
* Age CategoryThis question is required.
* RaceThis question is required.
* EthnicityThis question is required.
* Primary LanguageThis question is required.

Organizational Information

* Which of the following best describes your organization/where you are employed?This question is required.
* Which of the following best describes your funding status?This question is required.
* Which of the following best describes your organization/where you are employed?This question is required.

Information About You

* Indicate your level of experience providing technical assistance and consultation to early childhood programs on the scale below 1 being no experience and 5 being extensive experience This question is required.
* According to the rules for certfication the rationale box at the bottom of each item page must include a rationale for all positive ratings in the 1 column and all negative ratings in the 3, 5 and 7 columns. Provide the indicator number (i.e. 1.1) before the appropriate rationale. If you have not provided all necessary rationales we may not be able to complete the review your of your assessment(s). By checking the box below you are confirming that you have provided rationale for all of the indicators that did not receive credit in each item.
* By checking below, I acknowledge that I have read and agree to the following conditions: I understand that I am only eligible to apply for recertification within three (3) months of my original certification expiration date. I understand if I do not apply for recertification within the three month time-frame I will need to attend PAS Reliability Training in its entirety again. Registration is non-refundable.