Professional Learning Initiative Form

1
Full Name* This field is required.
First Name
Last Name
2
E-mail* This field is required.
3
Institutional Affiliation* This field is required.
4
Partnership AffiliationPrimary partnering organization for which your work is being recognized, if applicable.
5
Name of Representative from Partnering Institution
Representative First Name
Representative Last Name
Representative's Title
Representative's Email Address
6
Description of your contributions to the research-practice partnership. * This field is required.Please describe in up to 5000 characters how your service to this organization (and possibly others) make contributions that address problems of educational practice and improve K-12 schools (including an exemplar that characterizes such contributions to this organization). This may include: research-practitioner partnerships; professional development, talks, workshops, or consulting; writing briefs (for policy or research); publishing (manuscripts/briefs/policy statements) in outlets that practitioners or policy makers access; activism or advocacy; and all of the other great things that you do that we have not thought of specifically.
0/5000
Huge
Large
Normal
Small
Ok
Ok
7
Curriculum Vitae (CV), which provides a broader picture of your work and other efforts that may not have been emphasized in a narrative description.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Browse Files
Cancelof
Should be Empty: