Download PQAS Application

Pennsylvania Quality
Assurance System
PQAS Application
Specialty Discipline Professional Development Instructor
Specialty Discipline Technical Assistance Consultant
Pennsylvania Early Learning Keys to Quality
Effective 5/1/2015
Pennsylvania Early Learning Keys to Quality (Effective 5/1/2015)
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PQAS Certified Application
APPLICATION GUIDELINES
1. Qualifications: Application for Specialty Discipline Professional Development Instructor or Specialty Discipline
Technical Assistance Consultant* is intended for:
 Individuals who do not have early childhood/school-age educational backgrounds but have important
information to share (e.g., nurses, accountants, lawyers). These individuals possess a minimum
Bachelor’s degree from an accredited institution. If you have an ECE College Credit Calculation Tool
completed by your Regional Key, please submit that with your application.

Individuals with a professional license or other type of recognized credential. (A minimum of a high
school diploma accepted in certain circumstances).
*Technical Assistance Consultant must have a minimum of a Bachelor’s degree in specialty field .
2. Transcripts: Transcripts must be included for each degree held. Student copies of transcripts are acceptable
as long as the school name, student name, and degree are on the transcript.
3. Curricula Vitae or Resume: Attach an up-to-date resume detailing background and experience. This resume
must include:

Educational degrees from accredited institutions. Include year(s), degree(s) awarded, major(s) or
field(s) of study

Other professional credentials /related educational experiences

Experience as an adult educator /trainer
 Employment history
4. Letters of Reference: Provide two letters of reference which speak to your ability as an instructor. If
applicable, one letter of reference should come from a Professional Development Organization for whom
you provide instruction. Letters must be dated within the last six months prior to submitting the
application.
5. Professional Development: This consists of all of the categories identified below.
documentation for each category.
You must provide

PQAS Orientation: The online modules for the PQAS Orientation can be found at www.pakeys.org.
Login and click on PQAS. Once you have completed each workshop, print the certificate of
attendance and include that with your application.

Learning Standards Professional Development: The six hour course “Linking Standards, Curriculum
Framework, and Assessment” can be found in the Course Catalog on the PD Registry at
www.pakeys.org. Login to the Portal, click on PD Registry on the left hand menu, then click on the
Course Catalog tab. In the search bar, type “linking” to search for a location in your area to attend
this face to face course. Individuals working with school-age practitioners should take “Links to
Learning Foundations.”

Personal Professional Development: Applicants are required to document a minimum of 25 hours of
experience in instructing and/or consulting adults within the past three years. This may include
instruction/technical assistance in areas outside of early childhood education. If applying for both
Instruction and Consultation, the hours must be arrayed across both.
Pennsylvania Early Learning Keys to Quality (Effective 5/1/2015)
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PQAS Certified Application
6. PQAS Application Assurances Certificate: This is an online course in the PD Registry where the applicant certifies
that they have read, and will abide by, the assurances and NAEYC Code of Ethical Conduct, Supplement for
Early Childhood Educators. The course can be found in the Course Catalog on the PD Registry at
www.pakeys.org. Login to the Portal, click on PD Registry on the left hand menu, then click on the Course
Catalog tab. In the search bar, type “assurances”.
7. Application Fee: $70.00 application fee made payable to the PA Keys to Professional Development is used to
compensate peer reviewers. A separate fee of $70.00 is required each time a module/action plan needs to
be submitted for peer review. If submitting a professional development module and a technical assistance
action plan, a $70.00 fee must be submitted for each (total $140.00). Fees are subject to change.
8. Professional Development Overview and Module: Applicants for the category of Specialty Discipline Professional
Development Instructor, who are not planning to use pre-approved modules (e.g. First Aid), must submit an
professional development overview and module of the applicant’s own creation. The overview and module
must be in the format indicated in the Supporting Documents section of the PQAS page on the PA Key’s
website and should include all handouts used in the session. The professional development module must
demonstrate the applicant's ability to design at least a two-hour, but not more than four hour, session for a
specified target group. The rubric used to score modules is located on the PA Key website for review as
modules are developed
9. Technical Assistance Overview, Action Plan, and Progress Interaction Log: Applicants for the category of Specialty
Discipline Technical Assistance Consultant must submit an overview, action plan, and progress interaction log
of the applicant’s own creation. They must be in the format indicated in the Supporting Documents section
of the PQAS page on the PA Key’s website. The action plan must demonstrate the applicant's ability to
design an outline of action steps for addressing one goal of the technical assistance and should include all
handouts used to complete that goal. The rubric used to score modules is located on the PA Key website for
review as modules are developed.
10. Specialty Discipline Professional Development Instructor and Specialty Discipline Technical Assistance Consultant:
Individuals applying for both Instructor and Consultant approval must submit both a professional
development module and a technical assistance action plan.
11. Re-submission: If the module or action plan is denied, a letter will be sent outlining corrections to be made.
Applicants must send the corrected module or action plan including: overview, module/action plan and
progress interaction logs, handouts, and check or money order. If applicant’s module or action plan is denied
three times, applicant must wait one full calendar year from the third denial date before applying again. At
that point, applicant must re-submit a full application.
Pennsylvania Early Learning Keys to Quality (Effective 5/1/2015)
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PQAS Certified Application
APPLICATION PROCESSING TIMELINE
Once an application and all required documentation are received, the approval process should be completed within
90 days. An applicant with missing information will be notified by email and allowed 60 days from date of email to
complete their application. After that time, applications are considered denied and applicants will receive a letter
noting the need to reapply.
At the completion of the process, an applicant will receive a letter of notification indicating approval status. If
approved, the PQAS approval is valid for 5 years at which time another renewal application is required. In the case of
a waiver, PQAS approval will be granted congruent to the time of the Education Action Plan, for a maximum of two
years, at which time a renewal application is required. Click on this link to access the Education Waiver and Action
Plan.
Please include the following information with your application.
Contact (800) 284-6031 or https://pennsylvaniakey.zendesk.com with any questions.
 Application fee of $70.00 (for each module or action plan)
 Completed application
 Copy of transcript(s) for every degree; If you have an ECE College Credit Calculation Tool completed
by your Regional Key, please submit that with your application.
 Two letters of reference dated within 6 months
 PQAS Orientation certificates
 Pennsylvania Core Knowledge Competencies for Early Childhood & School-Age Professionals
 Adult Learning Principles
 Working Together to Making Learning “Stick” (for Consultant applicants only)
 Linking Standards, Curriculum Framework, and Assessment or Links to Learning PQAS certificate
 PQAS Application Assurances certificate
 Curricula Vitae or Resume
 Documentation of licenses/certification (if applicable)
 Waiver Application and Education Action Plan (if applicable)
 25 hours of professional development and/or technical assistance delivered to adults
 Module Overview & Module (Instructor applicants) (PD Template, Sample, Scoring Rubric Supporting
Documents)
 Technical Assistance Action Plan, Progress Interaction Log, and Overview (Consultant applicants) (TA
Template, Sample, Scoring Rubric Supporting Documents)
MAIL APPLICATION AND ALL DOCUMENTS TO :
Pennsylvania Key
PQAS
200 N. 3rd Street, 3rd Floor
Harrisburg, PA 17101
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PQAS Certified Application
APPLICANT INFORMATION
Date of Application: _________________
P ERSONAL INFORMATION ( REQUIRED INFORMATION )
Name: _________________________________________________________________
Home Address: __________________________________________________________
City: __________________________ State: ___________ Zip Code: _____________
County: ________________________ Phone (Home): __________________________
Personal Email:____________________________________________________
Date of Birth:___________________ Registry ID #:_____________
E MPLOYMENT I NFORMATION
Place of Employment: _____________________________________________________
Employment Address: _____________________________________________________
City: __________________________ State: ___________ Zip Code: _____________
County: ________________________ Phone (Work): ___________________________
Fax: __________________________ Work Email: ______________________________
T YPE OF A PPROVAL B EING R EQUESTED
(CHECK THE APPROPRIATE BOXES AND INDICATE ADDITIONAL INFORMATION.)
 Specialty Discipline Professional Development Instructor: I am submitting an original module, on the topic of my
specialty, in the format described in the PQAS Professional Development Module Template.
 Specialty Discipline Professional Development Instructor: I will use the following standardized module(s) and have
submitted with this application copies of my transcripts, certificate(s) and/or credential(s) showing my ability
to instruct on these modules.
____________________________________________________________________________
____________________________________________________________________________
 Specialty Discipline Technical Assistance Consultant: I am submitting an original action plan, on the topic of my
specialty, in the format described in the PQAS Technical Assistance Action Plan Template.
Pennsylvania Early Learning Keys to Quality (Effective 5/1/2015)
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PQAS Certified Application
L ETTERS OF R EFERENCE
Provide two (2) letters of reference which speak to your ability as an instructor. If applicable, one letter of reference
should come from a Professional Development Organization for whom you provide instruction. Letters must be
dated within the last six months prior to submitting the application.
E DUCATIONAL A CHIEVEMENTS



Include a copy of transcript for all degrees in the application package.
Specialty Discipline Instructors must attach copies of current certification or license to instruct in the
special discipline area(s) (for example Pediatric First Aid, CPR, Nursing License, and others that are updated
on a regular basis).
Include a copy of the Curriculum Vitae or Resume in the application package.
E XPERIENCE D ELIVERING I NSTRUCTION TO A DULTS
Provide information relevant to your experience (paid or volunteer) as an adult educator. Applicants are required to
document a minimum of 25 hours of experience in instructing and/or consulting adults within the past three years.
This may include instruction/technical assistance in areas outside of early childhood education. (Copy this page as
needed.) If applying for both Instruction and Consultation, the hours must be arrayed across both.
Specific
Date(s)
MM/DD/YY
Event Title
Name of
Organization
You were
Representing
Location
(City, State)
Number
of Hours
Target
Audience
 Early
Childhood
Persons
 Others
 Early
Childhood
Persons
 Others
 Early
Childhood
Persons
 Others
Pennsylvania Early Learning Keys to Quality (Effective 5/1/2015)
PQAS Application
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PQAS Specialty Discipline Application
AREAS OF EXPERTISE
K1 Child Growth and Development
Child Growth and Development
Learning Environment
Curriculum
Instruction
Family, Schools and Community Collaborations and Partnerships
Comprehensive Assessment System
Child Assessment
Observation, Reporting, and Documentation
Communication
Professionalism
Ethics
Advocacy and Leadership
Health
Safety
Nutrition
Mandated Reporter
First Aid
CPR
Water Safety and Lifeguard
Fire Safety
Emergency Preparedness
Program Organization and Administration
K2 Curriculum and Learning Experiences
K3 Family, Schools and Community and Partnerships
K4 Assessment
K5 Communication
K6 Professionalism and Leadership
K7 Health, Safety, and Nutrition
K8 Program Organization and Administration
45 hours of
professional
development and 10
years of experience
3 college credits and
10 years of experience
3 college credits and
45 hours of
professional
development
Competency Groups & Modules
90 hours of
professional
development
Knowledge Areas
6 college credits
Please identify your ability to instruct in the specific competency group(s) listed below, which are drawn from the Pennsylvania Core Knowledge Competencies for Early Childhood and School-Age
Professionals. Check only those areas that are appropriate for your experience and educational background, as supported by attached documentation. You may only select up to 10 competency groups.
Education/Experience Background (check one only)
______Certification Included
______Certification Included
______Certification Included
______Certification Included
______Certification Included
______Certification Included
Personnel
Te
Technology and Marketing
College Course
CDA
Other
Director Credential
SAC Credential
Technical Assistance
Pennsylvania Early Learning Keys to Quality (Effective 5/1/2015)
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PQAS Specialty Discipline Application
AREAS OF EXPERTISE SUPPORT
For each competency group selected above, please provide a sentence or two justifying why you believe this is an area of
expertise. Documentation must be included in your justification. On the supporting documentation, please identify the
competency group it supports.
Knowledge Competency
Areas
Groups
Ex. K2
Curriculum
Justification: Documents must be attached
ECE 402: Teaching and Curriculum at College of University. K2 indicated on transcript.
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Pennsylvania Early Learning Keys to Quality (Effective 5/1/2015)