TLI 2019 Participant Application

TLI 2019 Participant Application
Please complete the Application for consideration in the Teacher Leadership Institute for the 2019-20 program year (TLI 2019).

The TLI site will review all application submissions and select a group of Fellows for participation.

Participation in TLI is available for NEA members only. To learn more about TLI, visit our website https://www.teacherleadershipinstitute.org/
I. Personal Data:

Tell us about yourself
Full Name*

First NameLast Name
E-mail :*
Email where all TLI communications will be sent
TLI Site*
Mobile No. :*

Area CodePhone Number
Home Address :*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
II. Demographic Info:

Tell us about yourself
What is your gender?*

FemaleMaleNon-binary/GenderNon- ConformingPrefer not to say
Do you identify as transgender?

YesNoPrefer not to say
Birthdate:*

MonthDayYear
Ethnic ID*

American Indian/Alaska NativeAsianBlackCaucasianHispanicMulti-RacialNative HawaiianPacific IslanderOther
Primary Language group*

EnglishSpanishOther Indo-European LanguageAsian and Pacific Island LanguageOther
Secondary Language group*

EnglishSpanishOther Indo-European LanguageAsian and Pacific Island LanguageOther
III. Teaching Profession Information:

Tell us about your teaching career
School District*
School Name*
In what year did you begin teaching?*
Please provide only the year. (i.e. 19xx or 20xx)
Is your current position full-time or part-time?*

Full timePart timeOther
Grade(s) currently taught. Check all that apply.*

Pre-KK1st2nd3rd4th5th6th7th8th9th10th11th12thUngradedHigher EdAdultOther
Teaching Role*

Full-time classroom, resource, or spec. ed. teacherPart-time classroom teacherPart-time teacher and part-time teacher leader, e.g. mentorFull-time teacher leader, e.g., curriculum coordinator, mentorFull-time content specialist, e.g., reading or math
Main Subject taught*
Are you a National Board Certified Teacher (NBCT)*

YesNo
IV. Application Questions:
How can we promote and enhance the role of teacher-leaders in schools, districts, and in the profession to support student learning?*
Discuss your advocacy experience related to professional issues impacted by local, state, or federal policy. In what ways would you like to develop these skills, and how do you consider that to be part of your professional responsibility?*
What do you believe the role of the union or Association should be with regard to teaching and learning issues? How do you believe the union or Association should determine its priorities for advocacy and action?*
Please explain your motivation to participate in the Teacher Leadership Initiative. How do you think developing your leadership skills will impact the profession and the Association?*
V. Resume Upload:
Resume

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TLI 2019 Participant Application

I. Personal Data:

II. Demographic Info:

III. Teaching Profession Information:

IV. Application Questions:

V. Resume Upload: