FDCH 2021-22 – Alabama Council on Human Relations, Inc

Name (If you do not see your name on this list of approved providers, please contact Earl Tarver) *

Minnie Allen
Terri Allen
Vickie Andrews
Dorothy Bowen
Melinda Brown
Penny Davis
Phyllis Denney
Belinda Dowdell
Shana V. Duke
Miranda Edenesome
Dedra Evans
Takella Graves
Peggy Hall
Susan Jackson
Cicely King
Cody King
Janice Lofland
Golnaz Mazaheri
Kelly Metevier
Chelsea Mills-Stephen
Jehenne Moore
Susan T. Norris
Debra Palmer
Kathy Pierce
Kara Price
Sherri Tate
Jackie P. Waller

Email *

Phone *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

You are required to receive 3 hours of training annually. The ANNUAL GROUP TRAINING will count as a 2 hours of the required training. The ONLINE TRAINING will count as 1 hour of required training.

You must complete BOTH in order to meet the minimum requirements per the Agreement between Sponsor and Child Care Home Provider.

Please check the box below to pre-register for the Annual CACFP training. *

I will be at the Annual training on September 13, 2021
I will be unable to be at the Annual training

Please check the box below if you will be doing online training (you must complete online training and Annual training to meet the Annual training requirements) *

I will be completing training online
I will be unable to complete training online

Current age of children in care? Check all that apply.

If you provide infant care, you are required to complete the Infant Meal Pattern Online Training or receive technical assistance on site.

If you provide care to children 1 year or older, you are required to complete the Child Meal Pattern Online Training or receive technical assistance on site.

Signature *

Use finger, pen pad, or mouse to sign.

Date / Time *

Date

Time