Urban Alliance Teacher Institute 2023-24 Application
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College and Career readiness increasingly demands strong social emotional competence from young people. Join Urban Alliance, a proven leader in high school workforce development, for our Teacher Training Institute this school year to create access and learning opportunities for students in YOUR school.
Please note that approval from your administrator is required for eligibility to participate in this program.
Please contact Yezenia Sandoval at
ysandoval@theurbanalliance.org
with any questions.
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Contact Information
First Name
Last Name
Email Address
Phone
Gender Identity & Pronouns
For clarity on specific terms related to gender, please visit
this website
.
Which of the following best describes you?
Woman
Man
Nonbinary
Prefer to self-describe
Prefer not to answer
How would you describe your gender in your own words?
What pronouns do you use? Please
check all that apply
.
He/him
She/her
They/them
Prefer to self-describe
Prefer not to answer
What pronouns do you use?
Race & Ethnicity
Which of the following best describe you? This information will NOT be used in a discriminatory manner.
Select all that apply
.
American Indian or Alaska Native: (Navajo Nation, Blackfeet Tribe, Mayan, Aztec, Native Village or Barrow Inupiat Traditional Government, Nome Eskimo Community, et al)
Asian: (Chinese, Filipino, Asian Indian, Vietnamese, Korean, Japanese, et al)
Black or African American: (African American, Jamaican, Haitian, Nigerian, Ethiopian, Somalian, et al)
Hispanic, Latinx, or Spanish Origin (Mexican or Mexican American, Puerto Rican, Cuban, Salvadoran, Dominican, Colombian, et al)
Middle Eastern or North African (Lebanese, Iranian, Egyptian, Syrian, Moroccan, Algerian, et al)
Native Hawaiian or Pacific Islander: (Native Hawaiian, Samoan, Chamorro, Tongan, Fijian, Marshallese, et al)
White or Caucasian: (German, Irish, English, Italian, Polish, French, et al)
Something not listed above
Prefer not to answer
What is your ethnicity?
Please select...
Hispanic
Latino(a)
I do not identify as Hispanic or Latino(a)
Prefer not to answer
Employment and Experience
School of Employment
Role
Teacher
Counselor
Another role not listed
What is your role?
Which subject(s) do you teach?
Check all that apply.
STEM (Math/Science)
Humanities (English/Social Studies)
Elective (CTE, Foreign Language, Physical Education, Art, etc.)
College Prep/Advisory
Another subject not listed
Which subjects do you teach?
Which grade level(s) do you teach?
Check all that apply.
9th Grade
10th Grade
11th Grade
12th Grade
How many years have you been at your current school?
Less than a year
1-2 years
3-5 years
6-10 years
10-15 years
15+ years
How many total years of teaching/counseling/administrative experience do you have?
Less than a year
1-2 years
3-5 years
6-10 years
10-15 years
15+ years
Do you facilitate any after school programs, clubs, or sports teams?
Yes
No
Please specify which after school programs, clubs, or sports teams you facilitate:
Teacher Institute
Are you a previous TI instructor?
No
Yes
Which academic years?
2020-2021
2021-2022
2022-2023
Are you able to attend a mandatory full day training?
Yes
No
Are you able to facilitate nine SEL workshops to sophomore students in the 2023-2024 school year?
Yes
No
How do you intend to administer your 9 workshops?
During Advisory/Sophomore Seminar
During my current class(es)
After school
Another time not listed
When will you administer your 9 workshops?
Account Id
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How does social emotional learning (SEL) connect to your philosophy of education? Have you previously completed any SEL trainings and/or courses? If yes, through which organization?
(250 words)
Why do you want to be a part of Urban Alliance Teacher Institute? If you are a returning participant, please also describe what impact the SEL lessons had on your students and if there is anything you would change.
(250 words)
How will your school benefit from this training and program? (250 words)
How do you measure student success in your classroom?
Share your experience evaluating outcomes. (250 words)
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Referral Information
Were you referred to the TI program?
No
Yes
Referrer's full name:
Referrer's email:
Administrator Contact Information
Administrator's First Name
Administrator's Last Name
Administrator's Email Address
In order for your application to be considered complete, you must:
1) Complete and submit your application and
2) Your administrator must complete and submit the Administrator Approval Form that will be emailed to them
Yes, I understand and agree
Contact Information