FY24 Imagine U Intern Application Form

IMAGINE U - INTERN APPLICATION

ABOUT YOU
Full Name*

First NameLast Name
Phone Number*
Email *
Where the confirmation will be sent to
Home Address
Street Address
City
Zip Code
County
Home Address

Street Address

Street Address Line 2

City

Zip Code
Select Country, Zipcode and City here:
Street Address

Street Address

Apt or Unit #

City

Zip Code
What languages are you comfortable communicating in? (Select all that apply)*

EnglishSpanishSomaliArabicFrenchNone of the above
Do you currently live in the home where you plan to open your child care?*

YesNoNo, but I have secured housing and will move soon
Washington State Residency

The Imagine U program is open to current Washington State residents who have not previously opened and operated a licensed family child care business in Washington state. Applicants must currently reside in the home they plan to have approved for licensing.

IMAGINE U - INTERN APPLICATION

PROGRAM EXPECTATIONS
Are you available to attend mandatory trainings on either weeknights, Saturdays or Sundays?*

YesNo
Are you available to participate in weekly calls as needed?*

YesNo
Are you available to work at least 20 hours per month in your mentor's child care?*

YesNo
Scheduling and Attendance
- Applicants who are not available to attend regularly scheduled trainings will not qualify for the Imagine U program.
- Applicants who cannot complete the 20 monthly paid internship hours will not qualify for the Imagine U program.
Do you have a preferred mentor you wish to work with?*

YesNo
Mentor Information

IMAGINE U - INTERN APPLICATION

ECE SUBSTITUTE POOL
Are you an approved Early Care and Education substitute?*

YesNo
How many shifts have you worked as an ECE substitute?*

0 - 5 shifts6 - 10 shifts11 + shifts
Are you planning on continuing your work as a substitute throughout your participation in the Imagine U program?*

YesNo

SUBMISSION
Program Eligibility: The Imagine Institute does not discriminate in any program or activity on the basis of race, color, religion, gender, age, national origin, disability, marital status, or any other protected class.
By signing the space below, you are certifying that all information is correct and that you are the person completing this application. When you press the submit button, you will receive an email confirmation that your application was received. Please print for your records and retain as verification of your application.
Signature

Clear
FY 25 Accepted*

YesNo
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