Forms
Board
- Membership Application (B-20F-1)
- Conflict of Interest (Form 8B)
Families
- VPK Child Application Form English (AWI-VPK 01)
CCR&R (Child Care Resource & Referral)
- Schedule Updates
- Rate Updates
- Contact Information Updates
- Annual Provider Update (APU)
- Complaint Form
Child Care Providers - Resources/Tools
- School Readiness Provider Manual
- School Readiness Program Review Tool - FCCH (SR-61F-11)
- School Age Program Review Tool (SR-61F-26)
- Program Review Tool Infant-Toddler (SR-61F-41)
- New Provider/Owner Review Tool (SR-61F-10)
- Sample Schedule for Centers
- Sample Schedule for FCCH
- Sample Lesson Plan Template - Centers
- Sample Lesson Plan Template - FCCH
- Pre/Post Assessment Tool
- Diapering Procedures
- Training Tracking Procedure
- FCCH Suggested Inventory and Guide
- Center Suggested Inventory and Guide
- Prorated Training Hours
- Smoke Detector Testing Log
- Provider Max Rate Sheet and Gold Seal Differentials
- Request for Justification of Excessive Absences (SR-61F-13)
- Provider/ Client Rate Differential Worksheet - Sample (SR-61F-21)
- Reimbursement Instructions & Sample Report
Child Care Providers - School Readiness (SR)
SR Child Care Provider Documents - New Providers
- School Readiness Agreement - Center (Sample)
- School Readiness Agreement - FCCH (Sample)
- School Readiness Agreement - School Age (Sample)
- Character Education Self Study (SR-61F-25)
- Infant Toddler Curriculum Self Study (SR-61F-23)
- Preschool Curriculum Self Study (SR-61F-24)
- W-9 Form
- Holiday Schedule (Sample) (SR-61F-4)
- Holiday Schedule Modification Request
- Electronic Funds Transfer Form (EFT) (SR-61F-9) Revised
- Survey of Services and Proposed Rates and Fees (SR-61F-22) Revised
Informal Child Care Provider
- Informal Provider Abuse Background Check (DCF Form)
- Informal Provider Affidavit (DCF Form)
- Informal Provider Health and Safety Checklist (SR-61F-7)
- Informal Family Child Care Background Check (SR-61F-34)
- Relative/ Non-relative Affidavit (SR-61F-12)
Current SR Child Care Provider (Renewal Documents)
- School Readiness Agreement - Center
- School Readiness Agreement - FCCH
- School Readiness Agreement - School Age
- Annual Provider Update (APU)
SR Provider Miscellaneous Documents
- School Readiness Provider Manual
- Provider Change Notification (SR-61F-2) Revised
- School Readiness Parent Sign-in/out (SR-61F-8)
- School Readiness Parent Sign-in/out with Meal Program (SR-61F-20)
- Confidential Log of Absences for Protective Services (SR-61F-14)
- Accident or Unusual Incident Report (SR-61F-19)
- Character Education Self Study (SR-61F-25)
- Infant Toddler Curriculum Self Study (SR-61F-23)
- Preschool Curriculum Self Study (SR-61F-24)
Out of County Providers
SR Finance Documents
- W-9 Form (Complete only if changes occur)
- Electronic Funds Transfer Form (EFT) (SR-61F-9) Revised (Complete form only if changes occur)
- Holiday Schedule (SR-61F-4) Revised
- Holiday Schedule Modification Request
- Survey of Services and Proposed Rates and Fees (SR-61F-22) Revised
Child Care Providers - VPK Certification
- Form 10-11 Instructions
- Form AWI-VPK 10 (2011-2012) - Statewide Provider Registration Application Form
- Form AWI-VPK 11A - Class Registration Application - Instructors
- Form AWI-VPK 11B - Class Registration Application - Calendars
- Form AWI-VPK 20 (Summer 2012) - Statewide Provider Agreement
- Form AWI-VPK 20 (Fall 2012) - Statewide Provider Agreement
- Form AWI-VPK 20 - Attachment 1 - Pinellas
- Form AWI-VPK 20 - Attachment 2 - Multiple Sites
- Calendar Calculation Worksheet - Fall/Winter 2011-2012 (Excel)
- Calendar Calculation Worksheet - Summer 2012 (Excel)
- Calendar Calculation Worksheet - School Year 2012-2013 (Excel)
- Change Request Form Instructions (Revised 10/18/11)
- Change Request Form (Revised 10/18/11)
Finance
- W-9 Form
- Authorization Agreement for Automatic Deposit of Child Care Provider Payments (SR-61F-9) Revised
Child Care Providers - VPK Resources
- Sample Attendance Policy
- Student Attendance Long Form
- Student Attendance Short Form
- VPK Substitute Tracking Form (Excel)
Professional Development - Continuing Education Units (CEUs)
- Application Form - Single Training (Word)
- Application Form - Conferences (Word)
- Application Form - Training Series (Word)
- Request a Transcript
- Replace a Lost Transcript
- End of Year Training Report (SR-61F-37)
- School Readiness Training Approval Form (PD-81F-14)
EARLY LEARNING COALITION OF PINELLAS COUNTY, INC.
5735 Rio Vista Drive • Clearwater, Florida 33760
Phone: (727) 548-1439 • Fax: (727) 548-1509
