JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Counseling/Library Media Specialist Resource Design Team
Please fill this out if you are interested in participating! You will receive a stipend for your work.
* Indicates required question
Name
*
Your answer
Email
*
Your answer
What is your current location?
*
Your answer
Ethnicity/Race (Check all that apply)
*
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
Hispanic or Latine
White
Two or more races
Prefer not to answer
Required
What certification (Counseling or LMS) do you currently hold?
*
Counseling
Library Media Specialist
Other (i.e. I have helped counselors/LMS and have expertise)
Are you currently a facilitator for Candidate Support?
*
Yes
No
If so, what program do you currently contribute to?
*
Your answer
Are you available 2x monthly (agreed upon with your team) from February 1-May 1 to work on the project?
*
Yes
No
Other (please explain)
Is there anything else I should know?
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of National Board for Professional Teaching Standards.
Report Abuse
Forms
