Early Educator Health and Wellness: Building Resilience for Early Education Workforce, Children, and Families  

| Resume a previously saved form
Resume Later

In order to be able to resume this form later, please enter your email and choose a password.

Password must contain the following:
  • 12 Characters
  • 1 Uppercase letter
  • 1 Lowercase letter
  • 1 Number
  • 1 Special character
Application Instructions
thread has received funding from the Municipality of Anchorage (MOA), Anchorage Health Department (AHD) to provide health and wellness services for early childhood educators.

When we are healthy, both physically and mentally, we can be more attuned to our jobs and co-workers, and better able to meet the needs of the children we serve.

If you have completed the Building Resilience for Early Education Workforce, Children, and Families Training, you are eligible for $250; if you have completed the Introduction to FAN Training, you are eligible for $150; if you have completed the FAN Level 1 Practitioner Training, you are eligible for $1,350.

Thank you for participating in the MOA Early Educator Health and Wellness Grant, provided as a partnership by MOA to further your health and wellness journey. 

This project is supported by a grant awarded by the Municipality of Anchorage, Anchorage Health Department.   

The opinions, findings and conclusions or recommendations expressed in this publication/program/exhibition are those of the author(s) and do not necessarily reflect the views of the Municipality of Anchorage, Anchorage Health Department.

ELIGIBILITY REQUIREMENTS

For the Building Resilience for Early Education Workforce, Children, and Families AND the Introduction to FAN Trainings:
  • Educators who are currently employed in the Municipality of Anchorage
  • Educators who are a member of the Alaska SEED Registry
  • Educators who work in a licensed child care program within the Municipality of Anchorage
For the FAN Level 1 Practitioner Training:
  • Educators who are currently employed in the Municipality of Anchorage
  • Educators who are a member of the Alaska SEED Registry
  • Educators who work in a licensed child care program within the Municipality of Anchorage
  • Learn & Grow participants who have achieved or are working on Level 3

NOT ELIGIBLE

For the Building Resilience for Early Education Workforce, Children, and Families OR the Introduction to FAN Training:

  • Educators who work for a program outside of the Municipality of Anchorage
  • Educators who work for programs that are licensed by the Child Care Program Office (CCPO) and not the Municipality of Anchorage

For the FAN Level 1 Practitioner Training:

  • Educators who work for a program outside of the Municipality of Anchorage
  • Educators who work for programs that are licensed by the Child Care Program Office (CCPO) and not the Municipality of Anchorage
  • Educators who are not participants working on Level 3 in Learn & Grow
Prepare to Apply 
  • Use a computer desktop or laptop with the Google Chrome web browser. 
  • Download Chrome here.
  • Have the necessary documents nearby: (1) IRS Form W9 
Complete the Application   
  • Complete the application below, including uploading IRS Form W9. Questions with an (*) require a response.  
  • Read the acknowledgement statement. 
  • Check the signature box and type your name. 
  • Submit the application. 
  • Review the application.
  • Confirm the application to submit.  
Download/Complete/Upload IRS Form W9
  • Download IRS Form W9 here. 
  • Read the instructions for how to complete the IRS Form W9. 
  • Fully complete and sign the form. The program information on the W9 must match the program information entered on the application. Refer to "Example of Completed W9" below.
  • Save the completed form. 
  • Upload the completed form in Part 1, B of the application. An inaccurate or incomplete W9 may delay processing the application.
Translate the Application
  • Open the application using Google Chrome web browser.
  • Anywhere on the application form, right click for a drop-down menu.
  • From the drop-down menu, select “Translate to.”
  • Choose the preferred translation language.
Para traducir el formulario al español u otro idioma:
  • Abra el formulario con el navegador web Google Chrome. Descarga Chrome aquí.
  • En cualquier lugar de este formulario, haga clic con el botón derecho y verá un menú desplegable.
  • Selecciona "Traducir a".
  • Elija el idioma al que le gustaría que se tradujera.
Application Help 
PART 1: APPLICANT & PROGRAM INFORMATION
A. Contact Information
Information provided on the application must match information provided on IRS Form W9. Inaccurate or incomplete information may delay the processing of the application.













B. Demographics
This information is a requirement for enrollment.





C. Eligibility





Sorry, you are not eligible for this grant. You must be employed in the Municipality of Anchorage.

Sorry, you are not eligible for this grant. You need to be a current Alaska SEED member.

Sorry, you are not eligible for this grant. You must currently work in a licensed child care program in the Municipality of Anchorage.

Sorry, you are not eligible for this grant. You must be a Learn & Grow participant who has achieved or is working on Level 3.
PART 2: IRS FORM W9
A. Example of Completed IRS Form W9
Example of Completed IRS Form W9
  • Line 1: Name (as shown on income tax return) is complete.
  • Line 3: Federal tax classification is complete.
  • Line 5 & 6: Mailing address is complete. Note: The grant check will be sent to the address on the W9. 
  • Part 1: Taxpayer Identification Number (Social Security Number) is completed.
  • Part 2: Certification signature and date are completed. 
Example of W9.
B. Upload  Completed IRS Form W9  

To complete the IRS Form W9:  (1) Download IRS Form W9 here.  (2) Fully complete and sign. (3) Save and upload here.  An inaccurate or incomplete W9 may delay processing the application.  See above instructions for example of completed IRS Form W9.  
PART 4: ACKNOWLEDGMENT STATEMENT & SIGNATURE


By submitting this application: 
  • I understand that it is my responsibility to maintain records and other documentation to support the use of the grant services received.
  • I understand that this grant may impact my individual taxable income. I will seek assistance as necessary from IRS.gov or a tax consultant for guidance.

  • I understand that this grant is subject to audit and monitoring via surveys, focus groups, or other methods. I agree to participate in these activities as necessary or as requested.
      
  • I certify that the child care program I work for is located in the Municipality of Anchorage. 

  • I certify that I work for a licensed child care program.
  • I hereby certify that, to the best of my knowledge, the provided information is true and accurate.
Save my progress and resume later | Resume a previously saved form