Membership Form 2021

Membership Form

In order for CPLAN to be effective in achieving transformational and systemic change for the educational excellence for all students, we must first learn about our members. This form will helps us understand who you are, including your needs and interests. With this information CPLAN will be able to identify the resources we contain collectively to measure our ability towards accomplishing our goals. We believe we are stronger together.
Name *

First Name Last Name
Phone Number

Area Code Phone Number
E-mail *
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Representation

The CPLAN community is about serving all our children despite school choice. We want to consider ourselves school partners in finding ways to serve all children's no matter the needs. Please let us know the role you would have as part of the CPLAN community.
Please choose all that apply to your role in education: *

Parent Educator Education Support Staff Mental/Behavioral Health Professional Community Organization Elected Official Educations Resource
Please choose the type of school/s that applies to you: *

District (Regular Public School) Charter School Parochial School Home School METCO None of the above
Your Interests

Given the many benefits you gain from becoming a member of CPLAN, we want to learn what our members are most interested in, in regards to our children's education.
What are your interests with CPLAN? (choose all the apply) *

Being and remaining informed Developing or learning about teaching strategies Social & Emotional learning School Culture & Climate (including disciplinary practices) Special Education Gifted Education Building partnerships with educators Education Policies & Practices Curriculum & Instruction (including inclusion teaching methods) Academic Outcomes Family Engagement
Your Gifts and Talents

Our mission is to work collectively to achieve our goals by creating opportunities for everyone to plug in. The information below will help us identify what members already contain and what they would like to gain. There are several professional development opportunities that arise from time to time and CPLAN would share this information with interested members.
Occupation
Your job title
Employer
Company or Organization name
Choose all the professional skills you currently contain:

Public Speaking Grant Writing Community Outreach Strategic Partnership (includes fund raising) Presenting Graphic Design (for promotional materials & website) Marketing Research (includes compiling and presenting data) Social & Emotional Learning professional Teaching trauma sensitive classrooms School Culture and Climate (includes discipline) Special Education (includes student w/ disabilities) Gifted Education Teaching Diversity & Inclusion
Please let us know what skills you contain that could benefit the entire CPLAN community.
Member Status *

New member Existing member looking to update my information Existing member switching membership type Renewing membership
Where did you hear about us? *

Friend or Colleague Google Social Media News Article Promotional materials
Membership Type *
prev next ( X )
General Membership Free
~ Remain Informed ~ Attend FREE Events ~ Receive information through our newsletter ~ Develop relationships with school staff ~ Access to Parent Council training ~ Access to Affinity & Support Groups ~ Empower other parents to become active

VIP Membership $ 50.00
~ General Membership benefits plus... ~ Access to Personal/Professional Development Opportunities ~ Advocacy Coaching ~ Networking Opportunities ~ Leadership Training

Educator/ESP Membership $ 65.00
~ General Membership benefits plus... ~ Access to Professional Development Opportunities ~ Develop relationships with families ~ Increase Family Engagement ~ Networking Opportunities ~ Increase student success ~ Access to Panelist & Workshop opportunities

Total $ 0.00
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Membership Form

Representation

Your Interests

Your Gifts and Talents