CDA Application - New York Early Childhood Professional Development Institute

SUNY Corning Community College/New York Early Childhood Professional Development Institute Partnership

This application is for those individuals who intend to enroll in SUNY Corning Community College's Childhood Development Associate Prep (Micro-credential) through the New York Early Childhood Professional Development Institute.
Individuals admitted to this program through the New York Early Childhood Professional Development Institute are required to take credit bearing courses.
Individuals interested in enrolling in this program through the New York Early Childhood Professional Development Institute, if you have not done so already, must also complete their application found online at the Southern Tier Early Childhood Career Development Center's website (click here).

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Applicants applying through the New York Early Childhood Professional Development Institute will be enrolled in the Childhood Development Associate Prep (Micro-credential). This Micro-Credential program is not eligible for financial aid - students enrolled through this program are funded through the the New York Early Childhood Professional Development Institute.

Individuals wishing to enroll in the Childhood Development Associate Prep (Micro-credential) and utilize FAFSA and/or New York State financial aid must complete the SUNY CCC New Student Application (click here) and select Liberal Arts & Sciences Childhood Education (Teacher Education Transfer Degree) as the degree program.

All students are required to submit a Certificate of Residency (COR) . The COR Form along with directions on completing teh form can be found online at https://www.corning-cc.edu/current-students/certificate_of_residence.php.

Student Type*

First time at any college (as a full- or part-time student)

Transfer from another college

Former SUNY CCC student

Legal First Name*

Legal Middle Name

Legal Last Name*

IMPORTANT: When completing the application you are required to use your legal name to ensure accurate and timely processing of required documents.

CHOSEN NAME NOTE: Once you are a student at SUNY Corning Community College to use your chosen name please follow the directions located on our Chosen Name page found here.

Former NameIf you have records under a different name, give former name(s)

Mailing Address*

City*

State*

Zip*

County*

Telephone*

Cell Phone*

Email*

Date of Birth (mm/dd/yyyy)*

Have you ever been dismissed from a college for disciplinary reasons (not academic)?

Yes

No

Additional Information

The following background information is important for measuring the college's progress on equity goals and for grant proposals.

Are you a US citizen*

Yes

No

Did your father graduate from college?*

Yes

No

Unknown

Did your mother graduate from college?*

Yes

No

Unknown

Biological Sex*

Female

Male

Gender Identity*

Female

Male

Non-binary

Prefer not to disclose

Race/Ethnicity*

American Indian or Alaska Native

Asian

Black or African American

Hispanic or Latino

Native Hawaiian or Other Pacific

White

Prefer not to disclose

If Hispanic/Latino, please indicate your background

Central American

Dominican

Mexican

Puerto Rican

South American

Other Hispanic/Latino

Veteran Status and Veteran Administration Educational Benefits Information

Are you a veteran of the US Armed Forces?

Yes

No

Are you eligible for the GI Bill/VA Education Benefits?

Yes

No

Are you a spouse/dependent (child) of a veteran and eligible for VA Education benefits?

Yes

No

Educational Information

High School Information *

Graduated or will graduate from high school. Put date below.

Did not graduate from high school, but earned a state high school equivalency diploma [GED/TASC]. Put date below.

Did not graduate from high school nor earn a state high school equivalency diploma. Please call to discuss options.

Homeschooled. Put graduation date below.

Graduation/GED date (mm/dd/yyyy)*

Transcript Instructions

Ask your high school to send/fax your official transcript directly to SUNY CCC, or, if applicable, send us a copy of your high school equivalency (i.e. GED diploma and scores), or a copy of your External High School diploma. Mailing Address: Admissions Office, One Academic Drive, Corning, NY 14830. Fax: 607-962-9582.

Transfer Students

Ask your previous college to mail your official college transcripts directly to the SUNY CCC Office of Admissions. We will notify you of your status soon after your application and records are received. Upon your acceptance, you will receive directions for scheduling assessment tests, advising, and course registration.

High School currently attending or last attended*

High School mailing address (include street, city, state, zip)

Name & Address of Previously Attended College(s)

You can contact my high school counselor for admissions-related information

Yes

No

Release and Signature: The information provided in this application is correct to the best of my knowledge. The high school named in this application has my permission to release requested records to SUNY Corning Community College. I understand that by submitting this application, I will be contacted by SUNY Corning Community College for the purposes of beginning the enrollment process, which may include missing documentation, scheduling assessment testing, reminder calls for appointments, scheduling registration appointments, follow up communication to assist the student with enrolling in classes and preparedness for the first day of classes. SUNY Corning Community College will communicate to students through traditional communication, as well as email, automated calling, and text messaging. You will need to let the Office of Admissions know if there is a method in which you do not want to be communicated with.

Signature*

Date*

The Personal Privacy Protection law requires this notice to be provided when collecting personal information from individuals. The information on this application will be used to evaluate your request for admission. The application information will be maintained in the Admissions and the Registration and Records offices. The official responsible for maintenance of this information is the Provost. SUNY Corning Community College is an equal employment and educational opportunity institution, and does not discriminate on the basis of race, color, creed or religion, gender, sexual orientation, national origins, age or physical or mental disability, or other factors which cannot be legally used as the basis for employment or educational decisions.

Credit Bearing CDA Application