Alaska's Professional Development Registry System
Registration Form
Please complete the requested information below. The fields with an asterisk (*) indicate required fields.
General Information
First Name*
Middle Name
Last Name*
Birth Date*
(mm/dd/yyyy)
Social Security Number*
(last five digits)
User Name*
Current Home Address
Street1*
Street2
City*
Select City
Adak
Akiachak
Akiak
Akutan
Alakanuk
Alaska
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Buckland
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Chefornak
Chevak
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Chignik Lagoon
Chignik Lake
Chitina
Chugiak
Circle
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Clear
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Cordova
Craig
Crooked Creek
Deering
Delta Junction
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Dillingham
Douglas
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Egigik
Eielson AFB
Ekwok
Elfin Cove
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Elmendorf AFB
Emmonak
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Gakona
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Goodnews Bay
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Healy
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Homer
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Hooper Bay
Hope
Houston
Hughes
Huslia
Hydaburg
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Iliamna
Indian
JBER
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Lake Minchumina
Larsen Bay
Levelock
Lower Kalskag
Manley Hot Springs
Manokotak
Marshall
McGrath
Mekoryuk
Metlakatla
Meyers Chuck
Minto
Moose Pass
Mountain Village
Naknek
Napakiak
Nenana
New Stuyahok
Nightmute
Nikiski
Nikolai
Nikolski
Ninilchik
Noatak
Nome
Nondalton
Noorvik
North Pole
Northway
Nuiqsut
Nulato
Nunam Iqua
Nunapitchuk
Old Harbor
Other
Ouzinkie
Palmer
Pedro Bay
Pelican
Perryville
Petersburg
Pilot Point
Pilot Station
Platinum
Point Baker
Point Hope
Point Lay
Port Alexander
Port Alsworth
Port Heiden
Port Lions
Prudhoe Bay
Quinhagak
Rampart
Red Devil
Ruby
Russian Mission
Saint George Island
Saint Marys
Saint Michael
Saint Paul Island
Salcha
Sand Point
Savoonga
Scammon Bay
Selawik
Seldovia
Seward
Shageluk
Shaktoolik
Shishmaref
Shunknak
Sitka
Skagway
Skwentina
Sleetmute
Soldotna
South Naknek
Stebbins
Sterling
Stevens Village
Sutton
Takotna
Talkeetna
Tanacross
Tanana
Tatitlek
Teller
Tenakee Springs
Thorne Bay
Togiak
Tok
Toksook Bay
Trapper Creek
Tuluksak
Tuntutuliak
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Two Rivers
Tyonek
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Unalaska
Valdez
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Ward Cove
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Willow
Wrangell
Yakutat
State*
AL - Alabama
AK - Alaska
AZ - Arizona
AR - Arkansas
CA - California
CO - Colorado
CT - Connecticut
DC - Washington D.C.
DE - Delaware
FL - Florida
GA - Georgia
GU - Guam
HI - Hawaii
ID - Idaho
IL - Illinois
IN - Indiana
IA - Iowa
KS - Kansas
KY - Kentucky
LA - Louisiana
ME - Maine
MD - Maryland
MA - Massachusetts
MI - Michigan
MN - Minnesota
MS - Mississippi
MO - Missouri
MT - Montana
NE - Nebraska
NV - Nevada
NH - New Hampshire
NJ - New Jersey
NM - New Mexico
NY - New York
NC - North Carolina
ND - North Dakota
OH - Ohio
OK - Oklahoma
OR - Oregon
PA - Pennsylvania
PR - Puerto Rico
RI - Rhode Island
SC - South Carolina
SD - South Dakota
TN - Tennessee
TX - Texas
UT - Utah
VT - Vermont
VA - Virginia
VI - Virgin Islands
WA - Washington
WV - West Virginia
WI - Wisconsin
WY - Wyoming
Zip*
County
Select County
Other
Region*:
Select Region
Northern/Interior
Out of State
Southcentral
Southeast
view region map
Country Code
United States
Canada
Mexico
Afghanistan
Albania
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American Samoa
Angola
Anguilla
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Australia
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Cambodia
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Cayman Islands
Central African Republic
Chad
Chile
China
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Christmas Island
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Colombia
Comoros
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Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Cyprus
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Denmark
Djibouti
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El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
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Guinea
Guinea-Bissau
Guyana
Haiti
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Honduras
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Indonesia
Iran
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Ireland
Isle of Man
Israel
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Jordan
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Korea
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Lao PDR
Latvia
Lebanon
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Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
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Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russia
Rwanda
Saint-Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint-Martin
Saint Pierre and Miquelon
Saint Vincent and Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudia Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Svalbard and Jan Mayen Islands
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands, US
Wallis and Futuna Islands
Western Sahara
Yemen
Zambia
Zimbabwe
Contact Information
Home Area Code*
Home Phone*
Email*
Alt Area Code
Alt Phone
Other Information
Notes
Copyright 2015-2020 CCAoA. All rights reserved.
Please contact us at
ndshelpdesk@usa.childcareaware.org
if you encounter any difficulties.
Alaska Training Registry Module Version: 3.5.2
Date: February 24, 2020
Release Notes