Application
Program Information
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Program State:
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South Carolina
Arkansas
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Center Name:
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Facility Number #:
Only Numbers allowed for Facility Number
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Program Type:
Please check all that apply
* Please select program type
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Number of Staff:
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Only non zero numbers allowed
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Number of Children Served:
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Only non zero numbers allowed
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Ages of Children Served:
Check all that apply
Under 12 months
12-24 months old
24-36 months old
3 to 5 years old
* Please select ages served
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Program County:
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Address:
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City:
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Zip:
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Primary Contact Information
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First Name:
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Last Name:
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Job Title:
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Email:
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Direct Phone:
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Alternate Phone:
Are you enrolled in ABC Quality?:
Do you have a current, valid license or registration?:
Have you ever participated in the SC Program for Infant/Toddler Care?:
Does your program have the Breastfeeding Friendly Child Care designation?:
*
Are you currently enrolled in Better Beginnings?:
Please Select
Yes, Level 1
Yes, Level 2
Yes, Level 3
Yes, Level 4
Yes, Level 5
Yes, Level 6
No
* Required
Reason(s) for applying - tell us why you are interested in participating in this program:
Number of Classrooms:
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Under 12 months old
* Required
Only Numbers allowed
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12-24 months old
* Required
Only Numbers allowed
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24-36 months old
* Required
Only Numbers allowed
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3 to 5 years old
* Required
Only Numbers allowed
Participation Agreement - Please Check Boxes to Confirm You Understand
To be completed by Director/Owner or an Assignee
*
All checkboxes in this section are required
* Please check all the checkboxes in this section
Before beginning the Be Well Care Well program, all staff are required to complete the 1-hour Be Well Care Well Orientation training session. This orientation provides an overview of the program, introduces the Eight Dimensions of Wellness, and ensures all staff are well-prepared to fully engage in the well-being journey ahead. Orientation also offers an opportunity to connect with the assigned Well-Being Coach.
A Well-being Coach will visit monthly (or more) at agreed upon times.
I will participate as a member of my program’s Well-Being Committee.
I will facilitate staff participation in well-being activities by providing release time away from classroom responsibilities during work hours as needed.
A commitment from all staff to embrace well-being through fun and informative activities!
Selecting a Well-being Committee - Please Check Boxes to Confirm You Understand
*
All checkboxes in this section are required
* Please check all the checkboxes in this section
Please begin considering the individuals who will be on your Well-Being Committee. Each committee should include at least three members, though programs may include more as desired. When considering who you’d like on your Well-Being Committee, think about individuals in your program who are already engaged in fitness, health or well-being activities. You’ll want an enthusiastic committee of individuals who are fun, energetic and encouraging.
The expectation is that your Well-Being Committee meets with the Well-Being Coach monthly. A crucial meeting is at the beginning of the program to select well-being goals. After the initial meeting, the committee can decide how frequently it meets and when the meetings will take place during the workday. To receive BWCW services, the Director must agree to release Well-Being Committee members from their classroom responsibilities at agreed upon meeting times (typically 30 minutes)
The role of the committee is to share ideas and develop strategies to help their program achieve their well-being goals. The Well-Being Coach will communicate regularly with the committee members throughout the year to help plan well-being activities and to share opportunities and resources. The Well-Being Coach will support your committee all along the way!
We realize that everyone’s time is limited so rest assured that the work of this committee will not be overwhelming and everyone’s role can be adapted as needed to allow for participation.
Type your name below to acknowledge that you have read and agreed to all program and Well-Being Committee descriptions and expectations listed in this application:
* You must print your name
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Director Name
* You must enter date
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Date
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I am ready to identify my Well-being Committee at this time
Yes
No
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Please finalize your application by clicking the Submit Application button below.