Quality Improvement Funding Support Program (QIFS)
Department of Education and Early Childhood Development
The Eligible Employee Form is required when an eligible employee is hired and then any time there is a change to the employee’s eligibility type or
training level. Licensed Early Learning and Childcare facilities already participating in QIFS DO NOT NEED to submit an Eligible Employee Form for staff
already enrolled in the progam.
Name of early learning and childcare facility:
Licence Number:
Current hourly wage:
❑ New employee
Please check the appropriate box:
$/hour
(Not including QIFS/respecting the NB minimum
❑ Change in an employee’s status
wage of $11.70/hour effective April 01, 2020)
Name of eligible employee:
Effective Date:
(Temporary employees are not
eligible to receive QIFS funding)
Does this employee work in more than one licensed facility (multi-site)?
❑ Yes ❑ No
Average hours worked per week: (Employee must indicate estimated hours per licence #)
Licence # 1:
Hours:
Licence # 4:
Hours:
Licence # 2:
Hours:
Licence # 5:
Hours:
Licence # 3:
Hours:
Licence # 6:
Hours:
Eligibility type:
❑ Administrator
❑ Educator
Please only check one box
❑ Administrator/educator
❑ Relief staff (on call)
Early Childhood Education (ECE) training or University degree:
❑ Yes
❑ Yes
If no, would the employee be interested in enrolling in the ECE training?
(copy of the certificate, diploma or degree is required)
❑ No
❑ No
Request for Email address
To the attention of Licensed Early Learning and Childcare facility employees:
The Department of Education and Early Childhood Development would like to provide early childhood educators with information related to initiatives
undertaken by the Department. If you would like to receive this information, please provide your email address below. Your email address will only be
used for specific work related communication purposes, such as training and professional learning opportunities, and will not be shared or disclosed to
others. You may withdraw your consent at any time by contacting:
QIFS-SFAQ@gnb.ca.
As an employee working in licensed early learning and childcare facilities are you consenting to the use of your email address as described above?
Yes
No
❑
❑
Email address:
Employee’s declaration: Completing this form indicates that you have read and understood the included document: QIFS- Employee information.
❑
The eligible employee wage enhancement funding will be paid by participating facilities directly to you, over and above your regular wage as
indicated on this form. This will be accomplished through an hourly wage increase.
Eligible employee validation: The personal information requested on this form is collected under the authority of, and will be used for the purpose of
administering the New Brunswick Early Childhood Services Act. Disclosure of personal information is subject to the provisions of the New Brunswick Right
to Information and Protection of Privacy Act. It will be used to determine and verify your eligibility for employee wage enhancements.
Employee’s signature:
Date:
Operator/Administrator signature:
Date:
Operators/administrators should keep a copy of this form in the employee’s files and provide a copy to the employee.
Please return a properly completed form along with any
or by mail: Department of Education and Early Childhood Development,
certificate, diploma or degree by email: QIFS-SFAQ@gnb.ca
Quality Improvement Funding Support Program (QIFS)
Department of Education and Early Childhood Development
The Eligible Employee Form is required when an eligible employee is hired and then any time there is a change to the employee’s eligibility type or
training level. Licensed Early Learning and Childcare facilities already participating in QIFS DO NOT NEED to submit an Eligible Employee Form for staff
already enrolled in the progam.
Name of early learning and childcare facility:
Licence Number:
Current hourly wage:
❑ New employee
Please check the appropriate box:
$/hour
(Not including QIFS/respecting the NB minimum
❑ Change in an employee’s status
wage of $11.70/hour effective April 01, 2020)
Name of eligible employee:
Effective Date:
(Temporary employees are not
eligible to receive QIFS funding)
Does this employee work in more than one licensed facility (multi-site)?
❑ Yes ❑ No
Average hours worked per week: (Employee must indicate estimated hours per licence #)
Licence # 1:
Hours:
Licence # 4:
Hours:
Licence # 2:
Hours:
Licence # 5:
Hours:
Licence # 3:
Hours:
Licence # 6:
Hours:
Eligibility type:
❑ Administrator
❑ Educator
Please only check one box
❑ Administrator/educator
❑ Relief staff (on call)
Early Childhood Education (ECE) training or University degree:
❑ Yes
❑ Yes
If no, would the employee be interested in enrolling in the ECE training?
(copy of the certificate, diploma or degree is required)
❑ No
❑ No
Request for Email address
To the attention of Licensed Early Learning and Childcare facility employees:
The Department of Education and Early Childhood Development would like to provide early childhood educators with information related to initiatives
undertaken by the Department. If you would like to receive this information, please provide your email address below. Your email address will only be
used for specific work related communication purposes, such as training and professional learning opportunities, and will not be shared or disclosed to
others. You may withdraw your consent at any time by contacting:
QIFS-SFAQ@gnb.ca.
As an employee working in licensed early learning and childcare facilities are you consenting to the use of your email address as described above?
Yes
No
❑
❑
Email address:
Employee’s declaration: Completing this form indicates that you have read and understood the included document: QIFS- Employee information.
❑
The eligible employee wage enhancement funding will be paid by participating facilities directly to you, over and above your regular wage as
indicated on this form. This will be accomplished through an hourly wage increase.
Eligible employee validation: The personal information requested on this form is collected under the authority of, and will be used for the purpose of
administering the New Brunswick Early Childhood Services Act. Disclosure of personal information is subject to the provisions of the New Brunswick Right
to Information and Protection of Privacy Act. It will be used to determine and verify your eligibility for employee wage enhancements.
Employee’s signature:
Date:
Operator/Administrator signature:
Date:
Operators/administrators should keep a copy of this form in the employee’s files and provide a copy to the employee.
Please return a properly completed form along with any
or by mail: Department of Education and Early Childhood Development,
certificate, diploma or degree by email: QIFS-SFAQ@gnb.ca
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