CLARION UNIVERSITY OF PA
PA Key CDA (Child Development Associate)
Credential Renewal Program Form
Please complete the
top portion of the form completely. Use N/A for items that do not apply.
Items with an *
required entries. Students
participating in the PA Key CDA Credential Renewal Program must have a
This is a
non-degree program and as a result, students are not eligible to receive
financial aid. If you are interested in pursuing an associate's or
bachelor's degree program at Clarion University, please complete the regular
admissions process at
www.clarion.edu/apply. Students seeking
a degree may receive financial aid.
First Name*: Middle Initial:
Asian or Pacific Islander
American Indian/Alaska Native
Prefer not to answer
Daytime Phone Number:
If yes, name of county:
Do you have a
CDA credential*: Yes
Note: A student must have CDA credential to
participate in program.
institution awarding degree*:
Date credential awarded*:
Attended any other colleges?
college awarding degree*:
College Attendance Dates*:
Date degree awarded*:
High School Attended*:
High School City and State*:
If GED earned, date GED was received:
Have you attended Clarion University previously*?
Term for which you are applying*:
Year for which you are applying*:
Program you are applying for:
Key CDA Credential Program
How did you hear about the PA Key CDA
Friend, relative, or colleague
Search Engine (e.g. Google)
Professional Organization Affiliation
This form must be completed each semester of enrollment.
By clicking the submit button, you are verifying that the information
provided is accurate.