Request edit access
Illustrative Mathematics Facilitator Application
* Required
Email address
*
Your email
Last Name
*
Your answer
First Name
*
Your answer
Current Position & Title
*
Your answer
Place of Employment
*
Your answer
Work Address
*
Your answer
Home Address (Street and Apt)
*
Your answer
Home Address (City)
*
Your answer
Home Address (State)
*
Your answer
Phone Number
*
Your answer
About how many days will you be available to provide full day inperson Professional Learning during the school year? (Advance notice will be given; please explain any details regarding your schedule as needed.)
Your answer
About how many days will you be available to provide full day inperson Professional Learning during the summer? (Advance notice will be given; please explain any details regarding your schedule as needed.)
Your answer
In general, when are you available to provide twohour virtual trainings on weekdays?
Definitely available
Possibly available
Not available
During the school day
After the school day
Definitely available
Possibly available
Not available
During the school day
After the school day
How far are you willing to travel to deliver inperson professional learning? (All travel related costs will be paid by IM)
*
Local (no overnight travel)
Close (possible overnight travel)
Extended (overnight travel)
Years of experience teaching secondary mathematics
0 years
12 years
35 years
610 years
> 10 years
Grade 6 Math
Grade 7 Math
Grade 8 Math
Algebra 1
Geometry
Algebra 2
Integrated Math
Statistics
Precalculus or Calculus
Preservice Math Teacher Courses
0 years
12 years
35 years
610 years
> 10 years
Grade 6 Math
Grade 7 Math
Grade 8 Math
Algebra 1
Geometry
Algebra 2
Integrated Math
Statistics
Precalculus or Calculus
Preservice Math Teacher Courses
Years of experience providing the following types of professional learning
0 years
12 years
35 years
610 years
> 10 years
Facilitating large group professional learning (> 25 people)
Facilitating PLCs
1:1 Coaching
Total number of years of experience providing professional learning for middle school mathematics
Total number of years of experience providing professional learning for high school mathematics
Total number of years of experience providing other relevant professional learning experience
0 years
12 years
35 years
610 years
> 10 years
Facilitating large group professional learning (> 25 people)
Facilitating PLCs
1:1 Coaching
Total number of years of experience providing professional learning for middle school mathematics
Total number of years of experience providing professional learning for high school mathematics
Total number of years of experience providing other relevant professional learning experience
Level of comfort/experience building teacherâ€™s knowledge (Enter 15 with 5 being the highest comfort/experience)
1
2
3
4
5  Highest comfort / experience
Grade 6 Math
Grade 7 Math
Grade 8 Math
Algebra 1
Geometry
Algebra 2
Integrated Math
Statistics
Precalculus or Calculus
1
2
3
4
5  Highest comfort / experience
Grade 6 Math
Grade 7 Math
Grade 8 Math
Algebra 1
Geometry
Algebra 2
Integrated Math
Statistics
Precalculus or Calculus
Please rate your understanding of Math Content Standards as described in the Progressions Documents for the Common Core Math Standards
1  Novice
2  Emerging
3  Developing
4  Proficient
5  Expert
Ratios and Proportional Relationships (68)
The Number System (68)
Expressions and Equations (68)
Functions (8)
Geometry (68)
Statistics and Probability (68)
Number and Quantity (912)
Algebra and Functions (912)
Geometry (912)
Statistics and Probability (912)
1  Novice
2  Emerging
3  Developing
4  Proficient
5  Expert
Ratios and Proportional Relationships (68)
The Number System (68)
Expressions and Equations (68)
Functions (8)
Geometry (68)
Statistics and Probability (68)
Number and Quantity (912)
Algebra and Functions (912)
Geometry (912)
Statistics and Probability (912)
Please rate your experience with the following
1  I am unfamiliar with this topic
2  I know what it is
3  I have used with students
4  I have facilitated professional learning around this topic
5  I regularly use this topic/idea in my professional learning sessions
Five Practices for Orchestrating Productive Mathematics Discussions
Problembased instruction
Instructional Routines
Math Knowledge of Teaching
Setting Norms
1  I am unfamiliar with this topic
2  I know what it is
3  I have used with students
4  I have facilitated professional learning around this topic
5  I regularly use this topic/idea in my professional learning sessions
Five Practices for Orchestrating Productive Mathematics Discussions
Problembased instruction
Instructional Routines
Math Knowledge of Teaching
Setting Norms
List up to 5 recent presentations/workshops you have given on a national, state, district, and/or school level. Please include date, conference, presentation title, and number of participants.
*
Your answer
List any professional organizations of which you are currently a member and note your level of participation in the organization.
*
Your answer
Paste a video link or describe when you led a professional learning session.
*
Your answer
Write a brief reflection of the professional learning cited above including what went well and what you would change next time.
*
Your answer
Why you would like to be a facilitator for Illustrative Mathematics?
*
Your answer
How did you find out about the IM Certification program?
Twitter
Facebook
Other Social Media
An IM employee, contractor, or facilitator (please include name below)
Other:
Resume: Please name your resume as "First name Last name Resume", save a copy of your resume on your google drive, change sharing setting to "Anyone with the link can view" and add a link to the resume below.
Your answer
Send me a copy of my responses.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This form was created inside of Illustrative Mathematics.
Report Abuse

Terms of Service
Forms