Middle School Civics Standards Committee Recruitment SY 2021-2022

Created for Matt Walsh and modified for Jacob Koressel 08/20/2021 by Nhan Nguyen on 06/07/2021
Middle School Civics Standards Committee Recruitment SY 2021-2022

The Indiana Department of Education (IDOE) is gathering a list of participants who would like to be considered for the Indiana Academic Standards Middle School Civics Committee (HEA 1384). Additionally, the committee will collaborate as needed in order to accomplish the task of designing the Indiana Academic Standards for Middle School Civics. IDOE will assist and guide the process. Commitment includes four working virtual meetings throughout the 2021-2022 school year:
- September 30
- October 21
- November 9
- February 15, 2022
In order to meet the requirements for committee membership (HEA 1384), IDOE requests representation on the committee from the following demographics:
- Licensed secondary social studies educators;
- Higher education representatives with subject matter expertise; and
- Parents.
Those interested in serving must complete the form below. The deadline for responding to this request is August 27, 2021 . All interested members will be contacted about their status as a committee member. Teachers that are selected for this work will receive professional growth points (PGPs). Teachers will receive a minimum of 20 PGPs.
Name*

First NameLast Name
Work Email*

Confirmation Emailexample@example.com
Summer Email*

Confirmation Emailexample@example.com
Indicate if school is public, charter, nonpublic, or higher education.*
If you are a teacher, please provide the following information:
Superintendent or Principal Name

First NameLast Name
Superintendent or Principal Phone Number
Superintendent or Principal Email

Confirmation Emailexample@example.com
(Note: Teachers, listing the name and contact information of your supervisor indicates that you have your supervisor’s approval to engage in this process.)
School District, Institution of Higher Education, or Affiliate*
School Building*
City*
Check the grade and/or science and/or content you are certified to teach and have experience teaching at the secondary level (check all that apply)*

Grade 6 social studiesGrade 7 social studiesGrade 8 social studiesHigh school United States GovernmentUniversity level social studies content.University level teacher preparation program.I teach/have taught high school social studies dual credit.I teach/have taught Advanced Placement social studies courses.I am certified to teach English learners.I am certified to teach high ability.I am certified to teach special education.Not applicable
If selected University level social studies content. Please list area(s) of expertise.
If selected I teach/have taught high school social studies dual credit. Please list university, university course number, and course name.
Check the role that most closely aligns to you (check all that apply)

TeacherDistrict AdministrationBuilding AdministratorHigher EducationAffiliateParent
Check the school type you represent (check all that apply)

PublicNon-publicCharterInstitution of Higher Education
Check the setting your institution most-closely identifies with in Indiana*

UrbanSuburbanRural
Check the Indiana region that you most-closely represent*

NorthernCentralSouthern
Gender (Note: Demographic information is used solely to ensure Indiana’s diverse student population is well-represented.)

FemaleMaleI do not wish to answer this question.
Race (Note: Demographic information is used solely to ensure Indiana’s diverse student population is well-represented.)

American Indian or Alaska NativeAsianBlack or African AmericanNative Hawaiian or Other Pacific IslanderWhiteNone of the AboveI do not wish to answer this question.
Ethnicity (Note: Demographic information is used solely to ensure Indiana’s diverse student population is well-represented.)

HispanicNon-HispanicLatinoSpanishNone of the AboveI do not wish to answer this question.
I hold the following degrees (select all that apply)

Bachelor’s degree in educationBachelor’s degree in a field other than educationMaster’s degree in educationMaster’s degree in a field other than educationDoctorate in educationDoctorate in a field other than educationI do not hold any of the degrees listed.
Educators, do you have a parent or guardian you’d like to suggest be a part of this committee?

First NameLast Name
Contact Phone or Email
Comments
Thank you expressing your interest for in middle school civics standards-setting. Questions may be directed to Jacob Koressel jkoressel@doe.in.gov at the Indiana Department of Education.
Should be Empty: