MLTI Consultative Model
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1. MLTI Consultative Model

Please complete the following form if you are interested in taking part in the MLTI Consultative Model of Professional Development.

If you have any questions, please contact Juanita Dickson at juanita.dickson@maine.gov.

1. Requestor Information:

Requestor Information: Name
Email
Phone
Position

2. Please select your school name. If your school is not listed, please select Other and enter your school name in the field below.

Please select your school name. If your school is not listed, please select Other and enter your school name in the field below.

Other (please specify)

3. Please complete the following. If you are the principal, please enter "same as above" in the boxes.

Please complete the following. If you are the principal, please enter "same as above" in the boxes. Principal Name
Principal Email

4. Is your school interested in participating in the in-depth research program?

Is your school interested in participating in the in-depth research program? Yes

5. Why does does your school want to work with MLTI in the consultative model for professional development?

Why does does your school want to work with MLTI in the consultative model for professional development?

6. What percentage of the school's teachers would be committed to working with the MLTI professional development team?

What percentage of the school's teachers would be committed to working with the MLTI professional development team?

7. Please list the number of teachers by content area and include grade spans taught and the curricular focus for those teachers (ie what specific area will the professional development focus?). For example: Mathematics: 3 teachers, all teach 7-8, focus on understanding data representations.

Please list the number of teachers by content area and include grade spans taught and the curricular focus for those teachers (ie what specific area will the professional development focus?). For example: Mathematics: 3 teachers, all teach 7-8, focus on understanding data representations.

8. Please list the members of your schools leadership team that will consult with the MLTI professional development team. Include why each member is important to the team.

Please list the members of your schools leadership team that will consult with the MLTI professional development team. Include why each member is important to the team.

MLTI Consultative ModelExit this survey

1. MLTI Consultative Model

MLTI Consultative Model
Exit this survey