Classroom Storytelling Application 2017

Classroom Storytelling

GENERAL INFORMATION

Please fill out all the fields below.

Name*

First Name

Last Name

Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Preferred Phone*

Email*

YOUR CURRENT EMPLOYMENT INFORMATION

School Name*

Type of School*

Public Private Charter

School Address*

Address Line 1

Address Line 2

City

State

ZIP Code

School Phone*

School Fax*

Current Grade/Age Teaching*

Current Classroom Makeup (Choose all that apply.)*

Regular Inclusion Bilingual ESL Dual

How long have you been at your current position?*

YOUR EDUCATION BACKGROUND

High School/City*

Year Graduated*

Undergraduate institution(s). Please list all institutions attended and degrees obtained.

University/College 1*

Dates Attended*

Year Graduated

Degree Obtained

Major Area of Study*

University/College 2

Dates Attended

Year Graduated

Degree Obtained

Major Area of Study

Graduate institution attended.

Graduate Education University/College

Dates Attended

Year Graduated

Degree Obtained

Major Area of Study

Teaching Certificate(s)

1. State and Title of Certificate

2. State and Title of Certificate

Additional Degrees or Relevant Education

YOUR TEACHING BACKGROUND

How many years of teaching experience do you have?*

What ages/grade levels have you taught? Please include the dates for each.*

Have you ever been dismissed from a school or school district?*

Have you ever been suspended from or required to withdraw from any school or college?*

If you answered “yes” to any of the above, fully explain the occurrence and outcome.

ADDITIONAL INFORMATION

How did you hear about this program?*

Prerequisite Inquiry - Check if true.

I am applying to Classroom Storytelling as a prerequisite to the Early Literacy Leadership Academy.

Long Answer Questions

1. Why are you applying for Classroom Storytelling? What do you know about the School Literacy and Culture program? What do you hope to gain personally and professionally by participating in Classroom Storytelling? (Approximately 250 word maximum)

2. Describe your philosophy of early childhood education. How does that make your classroom an effective learning place? (Approximately 500 word maximum)*

File Upload

Please upload a letter of recommendation from your administrator.*

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