I am applying for registration to practise as an early childhood educator in the province of Ontario. The
College of Early Childhood Educators requires verification of my professional registration/licensure with
other regulatory bodies or regulatory authorities in any jurisdiction.
Please complete all questions in this form regarding my registration/licensure history with your organization
and send it back on my behalf to the College of Early Childhood Educators at:
438 University Avenue, Suite 1900
Toronto ON M5G 2K8
Telephone: 416 961-8558 Toll-free: 1 888 961-8558
Consent to Release Information
*Only this section should be completed by the applicant
to disclose information about my regulatory/licensing to the College of Early Childhood Educators (the
College), including information about my professional conduct that may not generally be available to the
public. I understand that information that is provided about me may be included in this form by the noted
regulatory/licensing organization and any additional follow up that the College may have with the noted
For regulatory/licensing organizations:
The regulatory/licensing organization must complete the rest of the form and then send it directly to the
• Question #1 is mandatory.
• For questions #2-7 only, please mark "n/a" for any question that does not apply.
Please ensure that you complete the signature and contact fields at the end of the form.