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This is an agreement between T.E.A.C.H. Early Childhood® IOWA and the scholarship recipient. Please read carefully and then sign this agreement. Both your official Contract (Form A) AND this Agreement must be signed and on file before any reimbursements or charge approvals will take place.

If I am awarded a T.E.A.C.H. Early Childhood® Scholarship, I will:

• Attend class, study, work hard and be a responsible student. This is a great opportunity that should be taken seriously.
• Regularly communicate with my scholarship counselor. My counselor is available to help guide me through the process of attending college as well as balancing my college, work and family responsibilities. He/She is just a phone call or email away and can answer many questions.
• Submit reimbursement forms in a timely manner. Registration forms (Form Rs) must be submitted in time for counselors to forward to the appropriate school. Tuition/Book Reimbursement forms (Form Bs or B/Cs) must be submitted for reimbursement of tuition, books and travel claims. If my model includes paid release time, I will sign the Release Time Form (Form Cs), be sure my director (if applicable) signs the Form C and help get it submitted for reimbursement for release time.
• Contact my scholarship counselor regarding any changes to my employment or college status, or if I am having difficulty in meeting my course/college requirements or scholarship contract.
• Submit my grades within 30 days of the close of the semester. Keeping records up-to-date is critical to continued support of this program.
• Pay my bills from T.E.A.C.H. and/or my college in a timely manner. It is my responsibility to ensure that I am meeting all of my obligations.
• Read and I understand the T.E.A.C.H. Participant Procedures Handbook. I understand that the T.E.A.C.H. Participant Procedures Handbook could change at any time. It is my responsibility to check the website periodically at www.iowaaeyc.org for updates.
• Uphold the required commitment to my program. I understand that if I break my commitment, I will be billed for the cost of my scholarship.
• I understand the benefits from T.E.A.C.H. are considered taxable income and I could receive a 1099 tax form each year that I utilize the scholarship.
• Acknowledge that individual application and participation information may be shared with funders or their designees and that name and place of employment may be shared with local resource and referral offices or community colleges if needed.
• Allow my employer to release employment information including date of employment, current position, age level of children in care, current salary or hourly rate, and the number of hours worked each week.

Child Care Center Staff Information must be completed by a Director or Owner.

If you are not a director or owner, please hit the “Save and Continue Later” button and send the link to your child care center’s director/owner.

Programs must demonstrate participation in or progress towards a quality initiative such as QRS, QPPS, Head Start, or NAEYC accreditation.

The T.E.A.C.H. Early Childhood® Iowa scholarship program offered through the Iowa Association for the Education of Young Children requires the participation of each scholarship recipient’s employing child care program. In the event this applicant is awarded a scholarship, I understand the program agrees to participate according to the scholarship option chosen. (This could include paid time off, money for tuition and books, and compensation at the end of the contract.)