Alabama Pathways Registry Application Form
Personal Information - All applicant information is confidential within the Alabama Pathways Registry System.

Please complete all requested fields. Fields with an asterisk(*) are required, and your application will not be processed unless all required fields are complete.

Please make sure to hit the SUBMIT button at bottom, or your application will not be transmitted to Alabama Pathways for processing.
  • Identifying Information

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  • Contact Information

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  • Demographic Information

  • The language in which a person speaks most proficiently.
  • Other language(s) in which a person speaks proficiently.
  • The language in which a person prefers to learn.
  • Formal Education Information

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  • Current Employment Information

  • If your employer has multiple sites, please specify the site at which you work.
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  • Employment History

    Please list ONLY previous Early Childhood Care & Education employers
  • Past Employer Information

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  • Supporting Documentation for Pathways Application

  • REQUIRED Education Documentation

    Please provide all of the following that may apply.

    If you are submitting a college degree diploma, YOU MUST SUBMIT THE CORRESPONDING TRANSCRIPT IN ORDER FOR THAT DEGREE TO APPLY TOWARD YOUR LATTICE LEVEL.

    (Supported document types include pdf, jpg, png, or gif. The size limitation is 10MB per file. There are also several smartphone scanner apps that will convert photos to pdf format. We recommend Genius Scan, available on the Apple iTunes and Google Play Stores. If you don't have a scanner, a cell phone photo of the document will do!)
  • (Supported document types include pdf, jpg, png, or gif.)
  • (Supported document types include pdf, jpg, png, or gif.)
  • (Supported document types include pdf, jpg, png, or gif.)
  • Please scan multiple Diplomas into ONE file. (Supported document types include pdf, jpg, png, or gif.)
  • Please scan all Transcripts into ONE file. (Supported document types include pdf, jpg, png, or gif.)
  • REQUIRED Professional Development Documentation

    Please submit any applicable professional development training taken within the last 2 years (2014-Present).

    (Supported document types include pdf, jpg, png. The size limitation is 10MB per file. There are also several smartphone scanner apps that will convert photos to pdf format. We recommend Genius Scan, available on the Apple iTunes and Google Play Stores. If you don't have a scanner, a cell phone photo of the document will do!)
  • Please scan Multiple Training Attendance Verification Certificates documents into ONE file in DATE ORDER. (supported file type include pdf, jpg or png,)
  • Optional Documentation

    Please submit any PAS, ITERS-R and ECERS-R Certificates.

    (Supported document types include pdf, jpg, or png. The size limitation is 10MB per file. There are also several smartphone scanner apps that will convert photos to pdf format. We recommend Genius Scan, available on the Apple iTunes and Google Play Stores. If you don't have a scanner, a cell phone photo of the document will do!)
  • Please scan all Certification documents into ONE file. (supported file type include pdf, jpg, png.)
  • Please scan all Certification documents into ONE file. (supported file type include pdf, jpg, png.)
  • Please scan all Certification documents into ONE file. (supported file type include pdf, jpg, png.)
  • Optional Documentation

    Please submit any current certifications or memberships in EC Professional Associations.

    (Supported document types include pdf, jpg, or png. The size limitation is 10MB per file. There are also several smartphone scanner apps that will convert photos to pdf format. We recommend Genius Scan, available on the Apple iTunes and Google Play Stores. If you don't have a scanner, a cell phone photo of the document will do!)
  • Please scan all Certification documents into ONE file. (supported file type include pdf, jpg, png, doc or docx.)
  • Please scan all Certification documents into ONE file. (supported file type include pdf, jpg, png, doc or docx.)
  • Signature and Date

    I, the undersigned, have read and agree to all statements indicated in this application. I hereby agree that the information provided in this application form is complete, accurate, and will be entered in the Alabama Pathways Professional Development Registry. I understand that I am responsible for information included in this application and agree to update my information with Alabama Pathways when applicable. I understand that Alabama Pathways is a public entity and will protect the confidentiality of personal information provided to the extent permitted under state and federal law.

    I understand that the information in my file will be used for the following purposes:

    Your information will be shared with the Alabama Department of Human Resources and Alabama Quality STARS for data collection and research purposes.

    -Alabama Pathways Professional Development Registry may use the information provided in the application form to compile and publish group data reports, and to recognize individual's education attainments (such as attainment of a Child Development Associate or Bachelor's degree).

    -Data compiled from the Alabama Pathways Professional Development Registry may be released to aid community and state planning to increase the quality and services of the early care and education community.

    Your name will not be released to advertisers. Information that could affect the safety and security of an individual (i.e. social security numbers, birth dates and personal addresses) will not be released to any individual or agency for any reason.
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