Reading and Literacy Added Authorization Interest Form - Spring 2020

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* 1. First Name (indicated on your Credential).

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* 2. Last Name (indicated on your Credential).

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* 3. LAUSD Email Address.

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* 4. Phone Number.

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* 5. Employee Number.

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* 6. School Site.

Name

Address

City / Town

ZIP / Postal Code

Phone

Principal

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* 7. Please indicate Clear/Level II California Teaching Credentials you currently hold.

	Clear/Level II.
Multiple Subject.	Multiple Subject. Clear/Level II.
Single Subject.	Single Subject. Clear/Level II.
Education Specialist.	Education Specialist. Clear/Level II.

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* 8. What is your current teaching assignment?

Elementary Teacher.

General Education Teacher.

Resource Specialist Teacher.

Special Day Class Teacher.

Other (please specify)

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* 9. How many years have you been teaching full-time (not including STSP/PIP Provisional Teaching)?

One year

Two years

Three years

Four years

Five years

Six or more years

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* 10. Confirmation.

I am interested in the Reading and Literacy Added Authorization program.

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* 11. Confirmation. (Must Attend)

I will attend Wednesday, February 26th 4:15pm meeting.

I will attend Thursday, February 27th 4:15pm meeting.

I will not attend at this time.

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* 12. Confirmation.

I understand to be considered I must submit my Principal Endorsement Form.

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* 13. Confirmation.

I understand to be considered I must submit my letter of intent and current resume.