2019-20 Clinical Education Facilitator Academy

Participant Application

The Florida Department of Education invites clinical education training developers to participate in the Clinical Education Facilitator Academy (CEFA). Participants will build content knowledge in four essential skills of clinical educators—growth mindset, content planning conferences, observation, and feedback—and receive support in order to revise or develop their organization's clinical education training program to incorporate the four skills. Please complete the information below if you are interested in participating.

If you have questions regarding the survey, or CEFA in general, please contact Lindsay Douglas at Lindsay.Douglas@fldoe.org or Kristen Gilley at Kristen.Gilley@fldoe.org.

Question Title

* Provide the following contact information.

Name

District, College or University

Role/Title

City

Email Address

Phone Number

Question Title

* Indicate whether your professional responsibilities at your district, college or university include each of the following.

	Yes	No
Developing clinical education training program curriculum and content	Developing clinical education training program curriculum and content Yes	Developing clinical education training program curriculum and content No
Delivering clinical education training to aspiring clinical educators	Delivering clinical education training to aspiring clinical educators Yes	Delivering clinical education training to aspiring clinical educators No
Facilitating professional learning experiences	Facilitating professional learning experiences Yes	Facilitating professional learning experiences No
Coaching aspiring or novice teachers	Coaching aspiring or novice teachers Yes	Coaching aspiring or novice teachers No
Supervising student teacher interns participating in an educator preparation program	Supervising student teacher interns participating in an educator preparation program Yes	Supervising student teacher interns participating in an educator preparation program No

Question Title

* Confirm your availability for one or more of the following Clinical Education Facilitator Academy dates and locations.
By selecting one or more of the following academies, you are committing to being available to attend all three face-to-face training dates.

May 6-7 and June 3, 2020 - Duval County

Question Title

* Enter any additional information you wish to provide.

Question Title

* Indicate your partner below, if you plan to attend the academy together and develop your program in partnership.
Please note, your partner will also need to register for the academy.

Name of Partner

District or Institution They Represent

Question Title

* Provide the following contact information.

Question Title

* Indicate whether your professional responsibilities at your district, college or university include each of the following.

Question Title

* Confirm your availability for one or more of the following Clinical Education Facilitator Academy dates and locations. By selecting one or more of the following academies, you are committing to being available to attend all three face-to-face training dates.

Question Title

* Enter any additional information you wish to provide.

Question Title

* Indicate your partner below, if you plan to attend the academy together and develop your program in partnership.Please note, your partner will also need to register for the academy.

* Confirm your availability for one or more of the following Clinical Education Facilitator Academy dates and locations.
By selecting one or more of the following academies, you are committing to being available to attend all three face-to-face training dates.

* Indicate your partner below, if you plan to attend the academy together and develop your program in partnership.
Please note, your partner will also need to register for the academy.