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2. Health & Human Services

   Ph: (970) 641-3244 | Fax: (970) 641-3738
   220 N. Spruce St, Gunnison, CO 81230
   https://www.gunnisoncounty.org/ecc

3. 
5. Early Childhood Continuing Education Award Submission Form

   This is a one-time award available to Early Childhood Teachers for completing formal coursework or a training of special recognition (EQIT or Pyramid 18 Sessions).

9. First Name*
10. Last Name*
12. Contact Number*
13. Email Address*
15. Mailing Address*
19. I have completed the below selected course(s) on or after 08/01/2021.*

    Check all that apply

    1. ECE 101
    2. ECE 103
    3. ECE 111

    1. Expanding Quality in Infant Toddler Care (EQIT)
    2. Pyramid 18 Sessions
    3. Other EC College Coursework
21. Certificate/Transcript Upload*

    Please upload a completion certificate or transcript for One (1) of your selected training completions

22. I-9 Upload*

    Please upload a completed I-9 Form

26. By entering your initials to the right you testify that all submitted information is yours and is correct. This will count as a legal signature.
27. Initials*
Leave This Blank:


29. 1. Receive an email copy of this form.
30. Email address

    This field is not part of the form submission.

31. Submit

* indicates a required field