Rodel Teacher Council Application

Please complete all fields in gray below and return via e-mail to Matthew Korobkin, Senior Program Officer, Rodel Foundation of Delaware at mkorobkin@rodelfoundationde.org. If you have questions, please call (302) 230-7009. Applications are due July 15, 2013. Candidate interviews will occur between August 1 and August 16, 2013. Contact Information Name: Click here to enter text. Click here to enter text. Click here to enter text. Click here to enter text. Click here to enter text. Click here to enter text. Personal E-Mail: Click here to enter text. School E-Mail: Click here to enter text. Date: School District: Click here to enter text. Choose an item.

School Name: School Address: School Phone: Home Address: Home Phone:

Professional Information What is your current role? What subjects do you teach? What grades do you teach? Click here to enter text. Click here to enter text. Click here to enter text. Choose an item. Choose an item.

How many years of classroom experience do you have? How many years have you worked in Delaware?

What leadership experiences do you have (mentor, learning community leader, union representative, etc.)? What is your highest level of Education? What is your degree(s)? Where did you receive your educator training (list all that apply) Are you National Board Certified? Choose an item.

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Rodel Teacher Council Application
Essay Questions Please complete the following essay questions and limit each response to 250 words.

Question #1: How many years do you see yourself in the classroom? What are your long term career and professional goals? Click here to enter text.

Question #2: How has your teaching and/or leadership contributed to measurable student achievement gains and the social and emotional development of students? Click here to enter text. Question #3: Describe an education policy at your school, in your district, in the state, or nationally that is of interesting or concerning to you. Describe how it impacts your instructional approach. If it is of concern, describe how you would go about fixing it. Click here to enter text. Question #4: Describe how you take initiative in your school or district. What has been the overall impact of your taking initiative? Click here to enter text. Question #5: How have you been recognized, in both formal and informal ways, in your school or district? Click here to enter text. Question #6: Describe how you personalize and differentiate instruction in your classroom? Click here to enter text. Question #7: Describe your most memorable moment in the classroom? Click here to enter text. Commitments As a member of the Rodel Teacher Council, we ask that you set aside time to participate in several events throughout the course of the year. On average, Teacher Council members can expect to commit between 2 to 4 hours per month. Most meetings will occur after school hours, in person or via webinar. There may be opportunities to engage in activities on weekends; we will work to accommodate teacher schedules. References Please list the names and contact information for two references. At least one of the references should be from an administrator or supervisor in your school district. Reference 1: Click here to enter text. Signature Applicant's e-signature: Click here to enter text. Reference 2: Click here to enter text.

Date: Click here to enter text.

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