Call for CoP Development Committee Members

Call for CoP Development Committee Members

Please complete the following form if you meet the CoP Development Committee Member Qualifications and Expectations identified in the call.
Name*

First NameLast Name
Email*
example@example.com
Institutional/Organizational Affiliation*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
DEC Membership

Note you must be a member of both CEC and DEC to apply. You can check on your current membership here or you can call CEC at 1 (888) 232-7733.
Member ID*
Membership Expiration Date*

MonthDayYear
Date
How many years have you been a member of DEC?
Demographic Information
Gender (Optional)
Race/Ethnicity (Optional)
Title/Role (Please select your current primary role.)*

Administrator/CoordinatorAdvocateAssociation LeaderBehavior Specialist/Mental HealthChild Care ProviderConsultant/Trainer/TA ProviderEarly Childhood EducatorEarly Childhood Special Education TeacherEarly Intervention PractitionerElementary Special Education Teacher (5+)Family MemberHead Start/Early Head Start ProviderHealth Care Provider/Public Health ProfessionalHigher Education FacultyOccupational TherapistParaprofessionalPhysical TherapistPolicymakerPsychologist/School PsychologistResearcherService CoordinatorSocial WorkerSpeech and Language TherapistState Administrator/StaffStudentOther
If you did not select family member for your current primary role, are you also a family member of a young child (age birth to 8) with a disability?

YesNo
Experience
How many years of experience do you have as a current or former CoP Facilitator?*

1-3 years4-6 years7-10 yearsMore than 10 years
Which one describes your experience as a CoP Facilitator? (Check all that apply and provide a description below.)*

Former DEC CoP (or SIG) FacilitatorCurrent DEC CoP Facilitator (with transition plan to exit within 1 year)Former Facilitator of a CoP outside of DECCurrent Facilitator of a CoP outside of DEC
Describe your past or present experience and/or interest in developing, growing, or sustaining a CoP for professionals in early childhood, early childhood intervention and/or early childhood special education:*
What DEC CoPs are you currently participating in? (Select all that apply.)*

DECIDEEarly InterventionFamily PartnershipInfant Mental HealthLeadershipPolicy and AdvocacyResearchService CoordinationN/A
What CoPs are you currently participating in outside of DEC?*
What interest, special skills or expertise would you bring to the DEC CoP Development Committee?*
What positive impact do you hope to have on the Committee and CoP facilitators it supports?*
What is one strategy you’d suggest for supporting the CoPs in providing equitable access to all DEC members and non-members?*
Volunteer Commitments
Are you willing to attend virtual meetings and contribute to committee work?*

YesNo
Are you willing to make the necessary time commitment (average 5 hours/month with opportunity to increase pending Committee tasks and activities)?*

YesNo
Have you read and fully understand the requirements, responsibilities and time commitments expected of DEC CoP Development Committee Members?*

YesNo
Please upload a copy of your current resume/curriculum vitae.*

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