2017 Memphis TLPN Teacher Leader Application

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Page 1: Personal Information

Personal Information

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First Name

Last Name

Street Address

City

State

Zip

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Primary Phone

Gender (optional)

Ethnicity (optional)

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Would you like to receive the Teach Plus Newsletter?

Newsletter (monthly)

News Blast (weekly)

Page 2: Teaching Information

Teaching Status

Are you a current teacher?

YesNoYou must be a current teacher in order to continue this application.

School where you currently teach

Please include the complete name.

School Address

City

State

Zip

District

School Type

Current Grade(s) teaching

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Main Subject(s) Teaching

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Please Specify (Main Subject Teaching Other)

Years of teaching experience you will have completed by August 2017

Are you a member of a union?

YesNoN/A

If yes, please enter union name here.

Years of standards-aligned instruction?

How did you hear about this opportunity?

Please Specify (How You Heard)

Where did you receive the majority of your teacher training prior to entering the classroom?

Please Specify (Teacher Training Other)

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Page 3: Short Answer Questions & Resume

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Short Answer Questions

1. How do you ensure your classroom goals and instruction are aligned to the goals of your program, team, school and/or district? (250-300 words)

2. As a Teacher Leader, how would you ensure your facilitation is impactful and relevant to adult learners? How would you anticipate and plan to meet the learning needs of adults? (250-300 words)

3. Describe a time when you advocated for change within your team, school, district or another organization: What was the change, why was it needed, and what actions did you take? Were you successful? (250-300 words)

4. Do you have experience utilizing any of the tools listed below? If so, would you feel comfortable leading others in exploring these tools? If not, would you feel comfortable learning to use one or more of these tools for facilitation purposes? (250-300 words)

List of Tools:

Ambitious Science Teaching
Concord Consortium
Core Actions
EngageNY - ELA
EngageNY – Math
EQuIP Rubric
EQuIP Student Work Protocol
Expeditionary Learning--ELA Grades 3-8 (Adopted Curriculum)
Illustrative Math Learning Progressions
Khan Academy
LearnZillion
Literacy Design Collaborative
Newsela
ReadWorks

Resume

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Page 4: References

References

Please provide two references (supervisor or colleague) with knowledge of your instruction.

Reference #1:

First Name

Last Name

Title

Company/School/Organization

Phone Number

Should we check with you first before contacting this reference?

Yes, please contact me firstNo, call them anytime

Reference #2:

First Name

Last Name

Title

Company/School/Organization

Phone Number

Should we check with you first before contacting this reference?

Yes, please contact me firstNo, call them anytime

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