CCAE Scholarship Application 2016

CCAE is pleased to offer scholarships for members interested in pursuing their own professional growth. Professional development opportunities can include registration fees for conferences, fees for credential programs (designated subjects, administrative etc.), costs for seminars, webinars, and more. Please visit www.ccaestate.org for more details.

Applicants should check with their CCAE section to see how they can apply for funds for the 2015-2016 school year.

Note: A short follow up questionnaire will be sent to all scholarship winners. Results will be compiled and analyzed for a full report to the Dollar General Literacy Foundation.

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* 1. Please indicate your contact information.

First Name:

Last Name:

School:

Email:

Phone:

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* 2. Please select your section.

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* 3. Please indicate your chapter.

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* 4. Are you a current member of CCAE?

Note: Applicants must have current individual membership or be a current member of current CCAE group membership. If you are not a current CCAE member, you may join or renew your membership online at www.cccaestate.org and click on membership. If you have any questions regarding your membership status, please contact the CCAE office at membership@ccaestate.org.

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* 5. What type of students do you principally work with? (Check all that apply)

ABE

ASE

CTE/Short Term Vocational Training

Correctional

Distance Learning

ESL

Family Literacy

GED

Adults with Disabilities

Older Adults

Parenting

Citizenship

Other (please specify)

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* 6. What is your primary function in adult education at the present time?

Other (please specify)

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* 7. What is the status of your position?

Full-time

Volunteer

Part-time (please specify hours per week)

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* 8. How long have you been in Adult Education?

Less than one year

1-5 years

6-10 years

11-15 years

16-20 years

21+ years

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* 9. Approximately how many students do you directly teach or serve annually?

1-15

16-50

51-100

101-500

501-1,000

1,000-5,000

5,000+

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* 10. Please indicate why you feel that you should be selected to receive a CCAE scholarship. Indicate your specific need and how you plan to use what you learn for Adult Education.

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* 11. I agree to complete the follow up questionnaire that will be sent after the CCAE state conference should I be selected as a scholarship recipient. I understand that completing the short questionaire is helpful for reporting purposes to the Dollar General Literacy Foundation.

Yes