Innovative Educator Form
The Innovative Educator Program is designed to encourage student teachers to be innovative in the classroom. Lessons should: 1) Ignite excitement for the content through the dynamic use of materials and allow for differentiated degrees of learning, 2) Offer a unique perspective to the topic(s) presented, and 3) Foster a sense of creative energy among students.

Directions: After submitting this online form, a lesson plan MUST be emailed to Julia Yu at A video of the lesson MUST ALSO be uploaded to Vialogues or Google Drive and be sent to

THIS APPLICATION, LESSON PLAN, AND VIDEO MUST BE SUBMITTED IN ORDER FOR YOU TO BE CONSIDERED FOR THE $300 EDTPA REIMBURSEMENT. If the 3 items are not submitted, your application will be considered incomplete and will not be considered.

Applications will be accepted between Oct. 2, 2017-May 18, 2018.

Please note that you will NOT BE ABLE to save and return to this form after it has been submitted.

Questions can be directed to or to 212.678.8219.

Good luck!

Name *
Your answer
Are you currently a student teacher with access to a classroom? *
Note: If you answered “no” you are not eligible to apply.
Email *
Your answer
Best phone number *
Your answer
Name of Cooperating Teacher: *
Your answer
Name of School *
Your answer
Grade level of students *
Your answer
Approximate number of students *
Your answer
Subject area *
Your answer
How is your lesson plan innovative? *
Your answer
What are the goals and objectives of the lesson(s)? *
Your answer
How will learning outcomes be measured or evaluated? *
Your answer
Is this a standalone lesson or part of a unit? If this lesson plan is part of a unit, where does this particular lesson plan fall within the unit plan? *
Your answer
Have you received your cooperating teacher’s approval to implement the lesson? *
Is this lesson part of your edTPA portfolio? *
Note: The entry CANNOT be an edTPA lesson.
Have you collected or have access to video consent forms from students? *
Note: Consent forms must be obtained from the students in the video. The NYCDOE consent form is acceptable.
Approximate date of lesson/instruction
Please put your initials in the box provided confirming that all of the above information is true and accurate. *
Your answer
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