2012 Educator Stories Survey
1
. Please share your contact information with us.
Please share your contact information with us.
Name:
School:
District:
City/Town:
State:
-- select state --
AL Alabama
AK Alaska
AS American Samoa
AZ Arizona
AR Arkansas
CA California
CO Colorado
CT Connecticut
DE Delaware
DC District of Columbia
FM Federated States of Micronesia
FL Florida
GA Georgia
GU Guam
HI Hawaii
ID Idaho
IL Illinois
IN Indiana
IA Iowa
KS Kansas
KY Kentucky
LA Louisiana
ME Maine
MH Marshall Islands
MD Maryland
MA Massachusetts
MI Michigan
MN Minnesota
MS Mississippi
MO Missouri
MT Montana
NE Nebraska
NV Nevada
NH New Hampshire
NJ New Jersey
NM New Mexico
NY New York
NC North Carolina
ND North Dakota
MP Northern Mariana Islands
OH Ohio
OK Oklahoma
OR Oregon
PW Palau
PA Pennsylvania
PR Puerto Rico
RI Rhode Island
SC South Carolina
SD South Dakota
TN Tennessee
TX Texas
UT Utah
VT Vermont
VI Virgin Islands
VA Virginia
WA Washington
WV West Virginia
WI Wisconsin
WY Wyoming
Email Address:
Phone Number:
*
2
. I am currently a:
I am currently a:
National Board Certified Teacher (NBCT)
Retake/Advanced Candidate
Take One! Participant
Other (please specify)
3
. What is your role in education? (Check all that apply)
What is your role in education? (Check all that apply)
Classroom teacher
Instructional Coach or School Based Staff Developer
Counselor
Librarian
Assistant Principal
Principal
Central Office Specialist
Higher Education Faculty
Other (please specify)
4
. Why did you pursue National Board certification?
Why did you pursue National Board certification?
5
. How did National Board certification impact your growth as a teacher?
How did National Board certification impact your growth as a teacher?
6
. How did National Board certification impact the learning of your students?
How did National Board certification impact the learning of your students?
7
. Is there anything else you would like to share about your story? (For example, you can use this space to highlight unique challenges or achievements you have experienced, include any relevant Internet links highlighting your work, describe any special relationships or circumstances with colleages, friends, and family that helped you certify, or tell us about interesting people you worked with as an educator, etc,.)
Is there anything else you would like to share about your story? (For example, you can use this space to highlight unique challenges or achievements you have experienced, include any relevant Internet links highlighting your work, describe any special relationships or circumstances with colleages, friends, and family that helped you certify, or tell us about interesting people you worked with as an educator, etc,.)
*
8
. Please select one of the following:
Please select one of the following:
I give permission for NBPTS to publicize my story.
I do not give permission for NBPTS to publicize my story. This information is for internal use only.
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