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Assessment Section Committee Application

Have you applied to serve on an ADE committee in the past 2 years?
Name
Address
Street Address
Contact Information
Demographic Information
Please fill in ethnicity if not listed above.
Education Experience
Current Cert
Current Certification(s) – select all that apply by holding Control or Command with your selections
Endorsements and Specialization(s) – please specify (e.g., Mathematics or Reading Specialist, English as a Second Language (ESL), Gifted, Structured English Immersion (SEI), Special Ed, etc.)
Indicate years of classroom teaching experience
Current position: Specify Grade(s)/subject(s), or district position
Specify type of area where you teach/work. For an individual school, the rural/urban classification can be determined by its mailing address using the Census Bureau’s American FactFinder. http://factfinder2.census.gov/faces/nav/jsf/pages/index.xhtml#none
Committee Preferences
Content areas preferred
Content areas preferred, qualified for Mark choices in order of preference (1st and 2nd choices are required)
Grade levels preferred
Grade levels preferred, qualified for Mark choices in order of preference (1st and 2nd choices are required)
(2 sections below: Content Areas and Grade Levels)
Please provide a short biography highlighting your educational background, qualifications, and any professional development in Arizona’s College and Career Ready Standards, Alternate Assessment, and English Language Proficiency Standards (if applicable).