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Dyslexia Specialist Cohort Application Form
Please fill out this application form if interested in applying for the Senator Martin Heinrich scholarship.
Please be mindful of application deadlines for the Winter/Spring and Summer Cohorts when applying.
For additional questions or inquiries about the Dyslexia Specialist Program, please contact Amy Stanton at amystanton@maycenter.org
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* Indicates required question
Email
*
Your email
First and Last Name
*
Your answer
Phone Number
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Your answer
Please provide your District, School, Position Held, and Number of Years in this Position.
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Your answer
Have you completed LETRS (
Language Essentials for Teachers of Reading and Spelling
) training?
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Yes
Currently in Year 2
Completed Year 1
Currently in Year 1
No
Please provide your total number of years teaching and position(s) held.
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Your answer
What is your commitment to the district? Do you have plans to move or transfer in the foreseeable future?
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Your answer
What relevant professional or personal experiences do you bring to this cohort?
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Your answer
Please describe your level of commitment and ability to work additional hours outside of your contract time over the next two years.
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Your answer
Do you have other significant professional or personal commitments that could cause you to be overextended?
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Your answer
Please explain your personal "why": Why is this learning critical to you and how do you hope to use this training in the future?
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Your answer
Please select the ethnic group(s) with which you identify:
*
Asian American / Pacific Islander / Asian
Black / African American / African
Hispanic / Latino / Latina / Latinx
Native American / American Indian / Indigenous
White / Caucasian / European
Multiracial / Multiethnic (2+ races / ethnicities)
Decline to state
Unknown
Required
"I understand that if I am accepted to this program, I am committing to all required coursework in the informational documents. I understand that if I drop out of the program after the second class, I will be required to pay May Center $3,800 and return all texts and materials, or I will be billed for those separately."
(
Applicant's signature below.
)
*
Your answer
"I understand the requirements of the CALP program, and I affirm that I will support this candidate in the completion of all requirements, including regularly implementing the SEE curriculum with at least one small group of students."
(
School Administrator's signature below.
)
*
Your answer
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