Contact Us Does your group care for any children between the ages of Birth to 3 years old? * RequiredYesNoName * Required First Last Name of Organization * Required County of Organization * Required Address of Organization * Required Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone * RequiredEmail * Required How did you hear about this training opportunity? * Required Project ACT's Website Facebook Project ACT Staff Person Tuesday Tidbits Word of Mouth Other What age groups do you work with? (check all that apply) Select All 0-1 years old 1-2 years old 2-3 years old 3-4 years old 4-5 years old School-Age What is your preferred training delivery method? (Project ACT cannot guarantee a specific delivery model at this time but will work to meet each program's needs.) * Required In-person - trainer comes to your program, trainer and participants must wear masks, participants must maintain social distance of 6 feet from trainer Virtual - training conducted over Zoom, each participant must be on their own device (laptop or tablet preferred) Please indicate that you understand the safety restrictions in place for in-person training listed below: * Required I understand the safety restrictions. - In-person trainings are limited to participants from the same childcare program, you may not combine staff from multiple sites or multiple programs. - Participants must maintain social distance of at least 6 feet from trainer. - All participants must wear masks for the duration of the training, regardless of vaccination status. - All participants must complete a personal health inventory prior to the training, and can only participate if they have passed the screening. - Any unvaccinated participants who are “exposed” to someone with COVID-19 may not participate in in-person training for 14 days following the exposure.Preferred Training Date - must be mm/dd/yyyy format * Required MM slash DD slash YYYY Training Time * Required : Hours Minutes AM/PM AM PM AM/PM Training Catalog What training topic are you interested in? See our Training Catalog to see all of our Special Needs training options. Number of Expected Participants * RequiredPlease enter a number greater than or equal to 15.There is a minimum of 15 participants needed. Technical Assistance (Mentoring & Coaching Sessions)Mentoring and coaching sessions can be provided. Participants receive 2 additional core of knowledge hours by participating in the mentoring and coaching sessions. (only provided to participants who have attended the training, required to attend both sessions to receive COK credit)Is your group interested in receiving Technical Assistance? Yes No