Reviewer Application


Professional Development Dossier (PDD)

If you are interested in becoming an External Reviewer for the Professional Development Dossier, please complete the following application:





Personal Information:
1. Title: First: Last:
2. 
Street Address: 

City: State:

Zip: Country:
3. School District:(If retired, put most recent)
4. School or Organization (If retired, put most recent)
5. Home Phone number (including area code)
 Example: 1234567890
6. Cell Phone number (including area code)
 Example: 1234567890
7. 

Email:

8. You may check more than one box in any category if applicable:
Classroom teacher  
School/District Administrator  
Curricular or Instructional Support Personnel  
Retired Educator  
Other   
9. Level of Professional Licensure
Level II  
Level III-A  
Level III-B  
National Board Certification  
Other    
10. 

Type of Professional Licensure

Early Childhood, Birth-Grade 3  
Elementary, K-8  
Specialty Area, K-12  
Middle Level Teaching, 5-9  
Secondary Teaching, 7-12  
Special Education, K-12  
Secondary Vocational-Technical  
Blind/Visual Impairment B-12  
Other   
11. 

Specify Special Education Type (i.e. behavioral disorders, severe disabilities, etc)

12. Teaching Endorsements
Agriculture  
Bilingual   
Business Education  
Family and Consumer Science  
Health Education  
Language Arts  
Library/Media  
Mathematics  
Modern, Classical and Native Languages  
Performing Arts (Music, Dance, Theatre)  
Physical Education  
Psychology  
Reading  
Science  
Self-Contained Classroom  
Social Studies  
Technology Coordinator  
TESOL  
Visual and Performing Arts  
Other   
13. Total Years of Teaching Experience
5 Years minimum of P-12 Teaching Experience  
5 Years minimum Combined P-12 Teaching and School Administration Experience   
5 Years minimum Combined P-12 Teaching and Post Secondary Teacher Education Experience   
14.  P-12 Grade Levels You Teach or Have Taught (Select all that apply)
Pre-K  
K  
1  
2  
3  
4  
5  
6  
7  
8  
9  
10  
11  
12  
15. 

Subject Areas and Teaching Experience (Type number of years experience)

 

You must complete this section in order for your application to be considered

 

Agriculture:

Buisness Education: 

Family & Consumer Science: 

Fine Arts: 

Health Education: 

Language Arts: 

Library/Media: 

Mathematics: 

Modern, Classical and Native Languages: 

Music: 

Performing Arts: 

Physical Education: 

Psychology: 

Reading: 

Science: 

Social Studies: 

Technology: 

Teaching English to Speakers of Other Languages: 

Visual and Performing Arts: 

Other: 

16. Write a short statement on the knowledge, experience, and expertise you will bring to the PDD Review process: