ITEEA Ballot Biographical Form

Your name has been submitted as a potential nominee for an office on the International Technology and Engineering Educators Association’s Board of Directors. The Elections Committee has been charged with evaluating all nominees to establish the candidates to be submitted to the membership on the ballot. Your assistance in furnishing the biographical data requested is necessary for fair evaluation by the committee and, if selected, for review by ITEEA’s voting membership.

Please complete the questions below as directed and restrict your responses to space provided. ADDITIONAL INFORMATION AND SUPPLEMENTARY SHEETS WILL NOT BE ACCEPTED.

Question Title

* 1. Office for which you have been nominated:

President-Elect - Supervisor/Administrator

Director of Region 1 - Teacher Educator

Director of Region 3 - Classroom Teacher

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* 2. Criteria for eligibility as an officer of the International Technology and Engineering Educators Association are:
A. A professional or life member of ITEEA.
B. Be a member of ITEEA the preceding three years.
C. Hold a position with responsibility in technology education.
D. An individual is classified as a Classroom Teacher, Supervisor or Teacher Educator (for purposes of nomination for a Regional Director's position or as President-Elect) if at least 50% of their professional assignment is in the respective area and/or they declare that the respective area is their major assignment or interest in technology education.

DO YOU WISH TO BE CONSIDERED A NOMINEE FOR THIS OFFICE?

Yes

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* 3. Full name and address:

Name:

School or Agency:

Position:

Address:

City/Town:

State:

ZIP:

Country:

Email Address:

Phone Number:

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* 4. Education (Dates, Institutions, Degrees, and Majors) in reverse order of attendance. (e.g., 1980-1984; University of Maryland; Bachelors; Technology Education)

Institution #1

Institution #2

Institution #3

Institution #4

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* 5. Teaching or Supervisory Experience (List in reverse chronological order). (e.g., 2014-2018; Herndon High School; Herndon, VA; Technology Education, Robotics, Manufacturing, CADD)

Position #1

Position #2

Position #3

Position #4

Question Title

* 6. Industrial and/or Other Significant Work Experience (List in reverse chronological order.) (e.g., 2007-2013; Engineering Solutions, Inc., Production Electronics Assembler)

Other Work Experience #1

Other Work Experience #2

Other Work Experience #3

Other Work Experience #4

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* 7. Professional Activities at the National/International Level (List organizations, offices, and committee activities) (e.g., 2006-2009; ITEEA; Membership Committee)

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* 8. Professional Activities at the State/Provincial Level (List organizations, offices, and committee activities) (e.g., 2004-2005: Virginia Technology and Engineering Educators Association; Membership Chair)

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* 9. Professional Activities at the Local Level (List organizations, offices, and committee activities) (e.g., 2000-2016; TSA; Chapter Advisor for Herndon High School)

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* 10. Research/Special Projects (List in reverse chronological order.)

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* 11. Special Honors (Honorary Listings and Special Awards) (List in reverse chronological order)

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* 12. Military Experience (if applicable):

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* 13. Honor Societies:

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* 14. Willingness to Serve

Yes, I certify that I am willing to serve in the office for which I have been nominated.

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* 15. Platform Statement (to be used on the official ballot):

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* 16. Submit Ballot Photo (High Resolution - minimum 300dpi - color photo) to kdelapaz@iteea.org

I agree to submit one high-resolution photo for use on the ITEEA ballot and in Technology and Engineering Teacher.

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* 17. ITEEA Conflict of Interest Policy:
All officers, directors, and employees owe an undivided duty of loyalty to the Association which requires them to act exclusively in the interests of the Association, without consideration for their own interests or concerns, when conducting its business. That duty includes avoiding situations where a conflict may exist or may appear to exist between the best interests of the Association and of the individual.
For example, such a conflict may arise if an individual performs duties for the Association and for another organization which competes with the Association.A conflict may also arise if an individual accepts gifts or other gratuities from an entity or person who does or is seeking to do business with the Association.
The Association wants to remind its officers, directors, and employees of that legal obligation and has distributed this policy in order to ensure that they fully understand that duty.For that reason, the Association asks that you sign this acknowledgement below.
The Association urges you to contact the ITEEA President and Executive Director if you want to discuss any questions which you may have about the obligation owed to the Association.
The Association wants to reiterate its appreciation and thanks for your efforts on behalf of it and its members.

I have read, understand, and agree to the ITEEA Conflict of Interest Policy.