Agency Designee Enrollment Form

Transcription

1 Agency Designee Enrollment Form The purpose of this form is to collect your contact information to authorize access to online services, program information, resources, newsletters, etc., as appropriate for your role and/or relationship with the Center for Teacher Innovation (CTI) Professional Teacher Induction Program. Your contact information will remain valid until you request an update or are removed from our database. You may notify to make a change. Name: Today s Date: (please print) Work Title Work Mailing Address: City: State: Zip Code: Primary Phone: ( ) Secondary Phone optional: ( ) Primary Secondary optional: Name of educational agency(ies) you represent: Indicate your induction-related role/s (check all that apply): Agency Representative provides induction leadership and oversees candidate and reflective coach participation. Credential Advisor provides guidance and/or support with candidate credential matters and/or eligibility. Assistant assists Agency Representative and/or Credential Advisor with induction responsibilities. Affiliate interested in induction resources/services if none of the above roles apply. Mailing list only no access to induction program records. If you are replacing someone from your agency previously assigned to the above role(s), please provide that person s name for removal from our contact list: Have you participated in any capacity with the CTI Induction Program since July 1, 2015? (e.g., currently a reflective coach, former candidate, etc.) No Yes state role and most recent year: Return this completed form to: Riverside County Office of Education Center for Teacher Innovation P. O. Box 868 Riverside, CA Or to: cti@rcoe.us 7/10/15

2 Professional Teacher Induction Program General Education Credentials Authorized for Teachers may be authorized for placement in the General Education Induction Program based on the following criteria: Teaching assignment or setting with access to instruct students on a regular basis for the school year. Matched with a reflective coach who holds a clear credential in a closely-aligned subject matter or grade span. CTC-issued Multiple Subjects or Single Subject credential dated on or before December 1 with one of the renewal codes shown below. The renewal code appears on a teacher s electronic credential ( General Education Credential Type Preliminary Multiple Subjects Preliminary Single Subject Credential Renewal Code R14I, R14S, R14T, RS3, PRO R14I, R14S, R14T, RS3, PRO Induction staff will review the eligibility status of enrolled candidates to authorize placement in the General Education Induction Program for teachers who indicate on the enrollment form that they want to clear a multiple subjects or single subject credential. Some (but not all) preliminary credentials may require completion of additional CTC statutory requirements based on the preparation route to earn the credential. Enrolled candidates will be advised if any of the requirements shown below apply to them. Resources for completion outside of induction will be provided. Possible CTC Statutory Clear Credential Requirements 6 Years Private School Experience Out-of-State Outside of the U.S. CPR Basic Skills (RC) Subject Matter (RSMC) Reading (READ) U.S. Constitution (US) English Learner (REL) Authorized candidates may request a clear Multiple Subjects and/or Single Subject credential recommendation from the Riverside County Office of Education when all clear credential requirements have been completed. Please see separate information for Education Specialist credentials. Eligible candidates may simultaneously participate in both Clear Education Specialist and General Education Induction Programs and will need appropriate experiences with students in both settings. Candidates in dual programs may not apply for the accelerated one-year Early Completion Option. For additional information or questions, contact our office at (951) or cti@rcoe.us. 4/7/15R

3 Three-Year Extension Two-Year Extension One-Year Extension CTC AL-3 (Issued one time with option for additional one- or two-year extension.) (Issued one time with option for additional one-year extension.) (Issued one time with an option for an additional one-year extension if the extenuating circumstances continue and sufficient progress has been made.) Purpose To obtain additional time to seek a position that will allow applicant to complete clear credential requirements. To obtain additional time to complete clear credential requirements while employed in a teaching position that provides eligibility for participation in an Induction or Clear Program. To obtain additional time to complete clear credential requirements. Qualifications Is not or has not been employed in a position that allows for the completion of a Clear or Induction Program, but needs a valid credential to seek employment. Only for teachers who were issued a preliminary multiple subjects or single subject with renewal code of R14I (SB 2042 issued on or after August 30, 2004.) Must be employed in a teaching position that allows for completion of the clear credential requirements, and is enrolled or is reenrolling in an Induction or Clear Program. Only for teachers who were issued a preliminary multiple subjects or single subject with renewal code of R14I (SB 2042 issued on or after August 30, 2004.) May have held a three-year extension. The teacher must be enrolled (or pending enrollment) in an Induction or Clear Program to complete clear requirements. For teachers who hold a preliminary or Level I teaching credential. If previously held a two- and/or three-year extension, applicant must be employed in a position to complete clear requirements. Requirements CL-884 includes applicants statement of why renewal requirements were not met and a plan for completion. CTC 41-4 application (with processing fee). CL-885 includes verification by employing agency and program sponsor. Applicants statement of why renewal requirements were not met and a plan for completion. CTC 41-4 application (with processing fee). Verification of Induction status (letter from program sponsor). Applicants statement of why renewal requirements were not met, documentation of the extenuating circumstances, and plan for completion. Verification of teaching experience (optional). CTC 41-4 application (with processing fee). 4/8/15R

4 Professional Teacher Induction Program Education Specialist Credentials Authorized for Special education teachers may be authorized for placement in the Clear Education Specialist Induction Program based on the following criteria: Teaching assignment or setting with access to instruct special education students on a regular basis and case management responsibilities that align with the credential specialty area. Matched with a reflective coach who holds a clear credential in the same specialty area as the candidate. CTC-issued Education Specialist credential dated on or before December 1 with one of the renewal codes below. The renewal code appears on a teacher s electronic credential ( Education Specialist Credential Type* Preliminary Level I Level I (Generic Focus)** Credential Renewal Code R19N R19L, R19M, R19D, R19F, RSN R19H, R19J, RSG, RSGN *Candidates with an Education Specialist Certificate of Eligibility must convert to a Level I Education Specialist credential during the first year of induction and prior to a clear recommendation. **Statutory requirements for Level I credentials based on a generic preparation program should be completed prior to induction enrollment (see chart below). Induction staff will review the eligibility status of enrolled candidates to authorize placement in the Clear Education Specialist Induction Program for teachers who indicate on the enrollment form that they want to clear a special education credential. Some (but not all) Level I credentials may require completion of additional CTC statutory requirements based on the preparation route for the credential. Enrolled candidates will be advised if any of the requirements shown below apply to them. Resources for completion outside of induction will be provided. Possible CTC Statutory Clear Requirements for Level I Credentials in California Out of State Outside of U.S. Level II Content English Learner (REL) Foundational Technology (COMP) Preliminary Health and/or CPR (HEAL) Basic Skills (RC) Subject Matter (RSMC) U.S. Constitution (US) Reading/RICA (READ) Level I Equivalent (Preliminary)* * Non-Special Education Pedagogy** (NEEP) Supervised General Ed Field Experience** (NSEE) Authorized candidates may request a clear Education Specialist credential recommendation from the Riverside County Office of Education when all clear credential requirements have been completed. Please see separate information for General Education credentials. Eligible candidates may simultaneously participate in both Clear Education Specialist and General Education Induction Programs and will need appropriate experiences with students in both settings. Candidates in dual programs may not apply for the accelerated one-year Early Completion Option (ECO). For additional information or questions, contact our office at (951) or cti@rcoe.us. 4/7/15R

5 Agency Representative Meetings Tuesday, August 18, , 2, 3, 5 & 6 Riverside County Office of Education, Conference Center Thursday, August 20, & 5 San Bernardino County Superintendent of Schools, Support Center Tuesday, August 25, Riverside County Office of Education Indio Thursday, August 27, 2015 Wednesday, August 26, Desert Mountain Educational Service Center Victor Elementary School District Second Avenue, Victorville, CA Wednesday, January 20, , 2, 3, 5 & 6 Riverside County Office of Education, Conference Center Thursday, January 21, & 5 San Bernardino County Superintendent of Schools, Support Center Tuesday, January 26, Desert Mountain Educational Service Center Friday, January 29, Riverside County Office of Education Indio Wednesday, April 13, , 2, 3, 5 & 6 Riverside County Office of Education, Conference Center Thursday, April 14, & 5 San Bernardino County Superintendent of Schools, Support Center Wednesday, April 20, Desert Mountain Educational Service Center Friday, April 22, Riverside County Office of Education Indio The meetings are scheduled from 9:00 a.m. 12:00 p.m. For additional information, please contact Barbara Howard, Director II at (951) Revised 6/16/15