TBI Team Training-Cohort 10

The Virginia Department of Education is seeking applications from school divisions for a tenth cohort of teams to receive intensive professional development in TBI the summer of 2020, and ongoing support from state specialists. This Application should be completed by an individual within the school division who will be responsible for a division or regional TBI Team.

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* 1. General Information:

Name of School Division:

Superintendents' Region:

Director(s) of Special Education:

Team Leader:

Team Leader's Email Address:

Team Leader's Telephone Number:

Each team member listed below needs to be in agreement with the following statement:

"I understand that as a staff member nominated for this team, I:

must be able to attend all three days of training, July 13-15, 2020;
am expected to remain in the current school division for the next year;
am able to share information effectively with others; and
must be able to attend a one-day training session in Spring 2021, and will be released from responsibilities for one additional school day in the next school year to attend or provide professional development."

It is strongly encouraged that the Director of Special Education or his/her designee be a member of the team, and that the other team members represent diverse roles involved with working with students with TBI (e.g., school psychologist, school nurse, special education teacher, speech-language pathologist, occupational therapist, physical therapist, athletic trainer). It is expected that the five team members listed below will attend the summer training session and the Spring 2021 follow-up training.

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* 2. Team Member Number 1

Name

Title/Role

Email address

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* 3. Team Member Number 2

Name

Title/Role

Email address

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* 4. Team Member Number 3

Name

Title/Role

Email address

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* 5. Team Member Number 4

Name

Title/Role

Email address

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* 6. Team Member Number 5

Name

Title/Role

Email address

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* 7. Background Information on School Division(s):

Number of students in school division(s) with a disability of TBI.

Number of concussions reported in the school division(s).

TBI Team Training-Cohort 10

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* 1. General Information:

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* 2. Team Member Number 1

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* 3. Team Member Number 2

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* 4. Team Member Number 3

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* 5. Team Member Number 4

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* 6. Team Member Number 5

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* 7. Background Information on School Division(s):

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* 8. Describe the existing level and nature of services provided to students with TBI/concussions.

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* 9. Describe the personnel and physical resources available in your school division(s) to support students with TBI/concussions.

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* 10. Describe the challenges personnel in your division(s) encounter in meeting the needs of students with TBI/concussions.

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* 11. Describe the outside resources recently accessed to address challenges.

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* 12. Describe the outcomes you hope to achieve through this training and technical assistance.

TBI Team Training-Cohort 10

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* 1. General Information:

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* 2. Team Member Number 1

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* 3. Team Member Number 2

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* 4. Team Member Number 3

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* 5. Team Member Number 4

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* 6. Team Member Number 5

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* 7. Background Information on School Division(s):

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* 8. Describe the existing level and nature of services provided to students with TBI/concussions.

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* 9. Describe the personnel and physical resources available in your school division(s) to support students with TBI/concussions.

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* 10. Describe the challenges personnel in your division(s) encounter in meeting the needs of students with TBI/concussions.

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* 11. Describe the outside resources﻿ recently accessed to address challenges﻿.

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* 12. Describe the outcomes you hope to achieve through this training and technical assistance.

* 11. Describe the outside resources recently accessed to address challenges.