Please submit your completed electronic application below. All applications are due by the last Friday in September. Keep in mind that there are limited positions available and acceptance into the program will be competitive.

  Part I. Applicant Information (All Fields Are REQUIRED)

School/Program Year Applying for:
First Name:
Last Name:
Maiden Name:
Title/position:
 
Type of Classroom:
School Type:
 
Grade Level:
School Name or Work Location:
 
Number of Students You Serve:
County or School District:
 
Number of Students with ASD:
School or Work Address
    
Street:
City:
 
Zip Code:
School or Work Phone:
 
School or Work Fax:
Home Address
    
Street:
City:
 
Zip Code
Home Phone:
 
Cell Phone
Email Address:


Part II. Narrative (see brochure)

Part III. Commitment and Approval

  
I understand that this training opportunity requires the development of a collaborative relationship with a CARD professional and the implementation of new practices in my classroom or school.
Applicant's Signature
Date
       
I approve of this teacher’s application and look forward to supporting his/her effort
Principal's Signature
Date
Final Checklist and Instructions before Submitting
  1. Did you complete all fields of this electronic application?
  2. Did you print this electronic application? (must print for signatures and faxing)
    Click here to print this page now.
  3. Did you answer Narrative questions in Part II of the application brochure on a separate sheet of paper for faxing?
  4. Did you request approval from your principal or administrator to participate in the Partnership Program?