SAC Credential Advisor, Endorser, Instructor If you are a human and are seeing this field, please leave it blank. Fields marked with an * are required Applicant Name * Position Applying For * SAC Advisor SAC Endorser SAC Instructor Email * Address (Street, City, State, Zipcode) * Phone Number * Work History - Please list your professional work experience here. Be sure to include place of employment, dates of employment, and job responsibilities. (Must have one year working directly with school-age children.) * Education - Please list degrees and credentials here. (Include dates earned and expirations if applicable.) * Do you have any of the following certifications? NYSNYS Accreditation Coach NYSNYS Accreditation Endorser NYS SAC Credential Endorser NYS SAC Credential Advisor NYAEYC T-Tap Credential (School-Age) NYAEYC - Coach Credential NYS OCFS - Health and Safety Training (SACC/DCC) NYS OCFS - Health and Safety Training for Directors (SACC/DCC) None Certificates - Please list any additional pertitnent certifications here. Please describe your knowledge of and experience with NYS OCFS SAC Regulations. * Please describe, including the time frames, your experience coaching other adults. * Please describe your knowledge and understanding of the SAC Credential Standards and/or Network for Youth Success Accreditation standards. * Please describe your experience training school-age professionals (if any). Please describe, including time frames, your experience as someone responsible for the growth of another adult. (Must have one year.) * If I am currently working in (or the adminstrator of) a licensed/registered program, I attest that * My program has been in compliance with all regulatory standards for the last two years. (Compliance history may be requested) My program has not been in compliance (compliance history may be requested) with OCFS Regulations, and I will explain below. N/A Explanation of Compliance Issues (if any) Please list any professional memberships. Is there anything else you would like us to know? Please provide the names and contact information (phone number and email address) of at least two individuals that can attest to your competence in the school-age child care field. * I understand that advisors, endorsers, and instructors are selected based on the requirements above, recommendations, and capacity.