SPRING 2015 CRI TEACHER SCHOLARSHIP ONLINE APPLICATION

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AWARD: $1000, non-renewable

APPLICATION DEADLINE (EXTENDED): Postmarked by February 1, 2015

APPLICATION REQUIREMENTS/DESCRIPTION: This scholarship is for high school teachers in west suburban Cook County seeking classroom funding. Applicants should demonstrate a dedication to enhancing their classroom environment. Please fill out the following application as completely as possible. Also, enclose answers to listed essay questions on a separate sheet of paper.

SELECTION PROCEDURE: Common Roots Initiative will select the scholarship recipient. How one will use the scholarship money to advance a vision for the classroom will be weighted heavily. Applicants that reach a second round of evaluation will be contacted and asked to provide a brief video of a lesson. The scholarship recipient will be notified by March 10, 2015.

To apply for the CRI Teacher Scholarship, please complete the following application. Two options are available for complete submission of application materials, but the first option is the preferred method:

1) Complete and submit the online application below (URL -- http://goo.gl/ZEQIss).
2) Send all materials – completed application and essay question answers – in one envelope via postal mail to Common Roots Initiative, c/o CRI Scholarship Committee, 161 W. Robinhood Way, Bolingbrook, IL 60440. Contact CRI to receive PDF version of application at info@common-roots.org.

All applications (including required documents) must be postmarked or submitted by February 1, 2015.

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CONSENT

Consent *

Select the box if you agree with the following statement:

I hereby certify that the information I have submitted is correct. I authorize the release of this information to members of CRI for review for scholarship review purposes only.

חובה

PERSONAL & ACADEMIC INFORMATION

Full Name *

Type your first, middle (if applicable), and last name.

Mobile Phone Number *

Type your 10-digit mobile phone number, including area code (xxx-xxx-xxxx).

Home Phone Number

Type your 10-digit home phone number, including area code (xxx-xxx-xxxx).

Work Phone Number *

Type your 10-digit work phone number, including area code (xxx-xxx-xxxx).

E-mail Address *

Type your full e-mail address, including the @ symbol.

School *

Type the full name of the school at which you teach.

Subject(s) Taught *

Type the names of the subject(s) that you teach.

Grade(s) Taught *

Type the grades to which you teach.

Extracurricular/Community Activities (in last 5 years)

Provide 4 pieces of information for each activity: 1) Name of Activity, 2) Your Title, 3) Month/Year Started, 4) Month/Year Ended. List a maximum of 5 separate activities.

First Extracurricular/Community Activity