2015 Early Career Educator of Color Leadership Award Program

Thank you for your interest in the NCTE Early Career Educator of Color Leadership Award. The deadline to apply is April 30, 2015, at 11:59 p.m. CST.

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* 1. Please complete the following information below.

Full Name: *

Gender: *

Home Address *

Home Address: *

City/Town: *

State: *

Zip Code: *

Permanent Email Address *

Home Phone Number

Mobile Phone Number

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* 2. Work-related information:

Subject Area(s) you currently teach:

Grade Level(s) you currently teach::

School/College/University Name:

Address:

City/Town:

State:

Zip Code:

Phone Number:

Administrator/Supervisor Name:

Administrator/Supervisor Email:

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* 3. NCTE membership is not required at the time of application. However, all award recipients must be current NCTE members at the time the award is accepted. Are you currently an NCTE member?

Yes

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* 4. I am a practicing PreK to university literacy educator of color in the first five years of a paid teaching career and I aspire to build a career in literacy education.

Yes

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* 5. What year of teaching are you currently in?

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* 6. I have full support from my school principal (PreK to 12) or a supervisor (university level) confirming release from my teaching duties for two consecutive years to attend the NCTE Annual Convention in November for 2015 - Thursday, November 19, 2015 to Sunday, November 22, 2015.

Yes

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* 7. Race/Ethnicity

African American

American Indian

Asian/Asian American

Latino/Hispanic/Spanish

Pacific Islander

Other (please specify)

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* 8. What is the highest level of school you have completed or the highest degree you have received?

High school degree

Bachelor's degree

Master's degree

Doctoral degree

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* 9. Colleges/Universities Attended:

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* 10. Please provide a brief history that indicates when, where, and what you have taught during your career.

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* 11. School Profile: Please provide a profile of your school, including student demographics.

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* 12. Ambitions/Goals: In 350 words or less, please share your ambitions and/or goals as a literacy educator.

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* 13. Needs Assessment: In 350 words or less, please describe your need for the scholarship and how the program benefits and objectives could help you achieve your ambitions.

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* 14. Project Interests: In 350 words or less, please describe the types of projects or professional leadership work in which you are interested in.

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* 15. Professional Growth: In 350 words or less, please describe how you feel your experience in this award program will strengthen your career in education.

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* 16. Please provide a short bio.

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* 17. * Reference Letter: You will need to provide a letter written from a colleague who is familiar with your professional work and can attest to your accomplishments and potential as a literacy educator. Please complete the information listed below as it relates to the individual who will serve as your reference.

Name of Colleague:

Colleague's Organization/Affiliation:

Colleage's Current Position:

Mailing Address:

City/Town:

State:

Zip Code:

Colleague's Email Address:

Colleague's Phone Number:

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* 18. Support Letter from School Administrator or Supervisor: To complete your application, please have your school administrator or supervisor sign the letter of support which can be downloaded from NCTE's website at www.ncte.org/awards/leadershift.

Please submit the completed letter of support to NCTE Award Program Manager Carrie Stewart at cstewart@ncte.org by May 7, 2015.

Yes, I will download and return the the support letter with the appropriate signature.

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* 19. If you have any suggestions and/or questions about the award program or this form, please share them below. Thanks for your interest and have a wonderful day.