Early Childhood Forms


Caregiver Background Check

Caregiver background check includes the review of criminal records for convictions of serious crimes or a history of improper behavior.  Students enrolled in the following programs at NWTC must complete a background check via the DCF Child Care Provider Portal:

Early Childhood Associate Degree Program
Early Childhood Assistant Teacher Technical Diploma
Inclusion Certificate
Preschool Certificate

Complete this form to begin the process and return it to Stacey Felton via email, fax it to 920-491-2660, or mail to: NWTC, Attn: Stacey Felton, Room HS310, 2740 West Mason Street, Green Bay, WI 54303.

Download the Caregiver Background Check Form

Child Care Health Report

Health Report is mandatory for all caregivers in the state of Wisconsin.

Functional Ability Checklist

New program students must complete this functional ability checklist prior to beginning their program and practicum student teaching experiences. Use the following form and submit it for consideration by the Early Childhood Team at Northeast Wisconsin Technical College.

Download the Functional Abilities Assessment

Program Shirt

Students are required to wear a program polo to represent NWTC when working at your practicum center. Sample shirts are available in the lab for sizing purposes. Click here: to order your shirt. (Please note that these shirts tend to run small. If you typically wear a medium, you may want to order a large.) 


Student Photo ID

Students are required to wear a photo ID to represent NWTC when working at your practicum center. You can get one in the Student Involvement Office (SC118) and there is no charge. Please bring a state issued photo ID and know your student ID.

Credit for Prior Learning

Credit for Prior Learning for the experienced teacher. Learners with extensive credit, credentials, and experience in the area of early childhood education can receive credit for prior learning. For more information on the Credit for Prior Learning 3 Credit course or the Fast Track Program contact Mary Beth Boettcher. Click here for information about upcoming class offerings.


Questions? Contact:

Stacey Felton

(920) 498-6255 or (800) 422-NWTC, Ext. 6255

 Mary Beth Boettcher

(920) 498-5410 or (800) 422-NWTC, Ext. 5410