Apply for Internationally Educated Early Childhood Certification

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The information collected on this form will be used for certification under the Early Learning and Child Care Act and Regulations. The information is collected under the authority of the Early Learning and Child Care Board and managed in accordance with the Freedom of Information and Protection of Privacy Act. If you have any questions about the collection, use or disclosure of your personal information, please contact the Early Learning and Child Care Board, 902-368-6513.

Identification

First Name

Middle Initial

Last Name

Address 1

Address 2

City, Town, or Community

Province

Postal Code

For example C1B 0X1 or 12345

Country

Telephone Number

For example 902-555-5555

Email Address

Date of Birth

Previous Name

If you were educated or previously certified in a name other than that used above please state the other name.