1810-new SAF Application Data Collection_6 12 23

Office of Elementary and Secondary Education

Effective Educator Development Division

School Ambassador Fellowship Program - Annual Online Application Candidate Data Collection

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Application Overview	Notes/Description/Reporting Format
Welcome to the School Ambassador Fellowship Program on-line application system! The School Ambassador Fellowship is designed to support the Department’s efforts in improving educational outcomes for students and families by involving school-based stakeholders in the development and implementation of national education policy. To be considered for the 2022-2023 School Ambassador Fellowship cohort, you must use this online system to submit a complete application. A complete application includes the following: Attestation of Eligibility Verification of Experiences Personal Statement Project Abstract Recommendation Forms Current Resume and Cover Letter The deadline for submitting your online application is 11:59 pm EST on XXX XX, 20XX. You may revise and/or submit information in your application any time prior to the deadline before completing your application. You may contact [email protected] with any questions or concerns about the application process or about your specific application submission.	Introductory language intended to orient applicants to the online application parts and expectations.
Section A. Verification of Eligibility	Notes/Description/Reporting Format
I am a U.S. Citizen or Permanent Resident.	Drop down selection or radio buttons: (Options: Yes/No)
I am currently a teacher (i.e. classroom teacher, literacy coach, math coach, etc.), administrator (i.e. principal, assistant principal, dean district level administrator, etc.), student support educator (i.e. social worker, psychologist, etc.), or other school professional (i.e. nurse, librarian, etc.) and anticipate being employed in this role throughout the 2023-2024 school year.	Drop down selection or radio buttons: (Options: Yes/No)
I am employed by a traditional public, charter, private, virtual, military (DoDEA), or tribal/BIE school that serves students from preschool through twelfth grade.	Drop down selection or radio buttons: (Options: Yes/No)
I have at least 5 years of educational experience as a teacher (i.e. classroom teacher, literacy coach, math coach, etc.), administrator (i.e. principal, assistant principal, dean district level administrator, etc.), student support educator (i.e. social worker, psychologist, etc.), or other school professional (i.e. nurse, librarian, etc.).	Drop down selection or radio buttons: (Options: Yes/No)
Section B. General Information	Notes/Description/Reporting Format
First Name	Short answer text field – required
Middle Initial (Optional)	Short answer text field - optional
Last Name	Short answer text field – required
School Name	Short answer text field – required
School Address	Short answer text field – required
School City	Short answer text field – required
School State	Drop down selection - required (Options: US states and territories)
School Zip Code	Short answer text field – required
School Phone Number	Short answer text field – required
School Type	Drop down selection - required (Options: Traditional Public, Public Charter, Private or Private Charter, Parochial, Virtual or Online, DoDEA, Other School Type)
Current Job Role	Drop down selection - required (Options: Fulltime Classroom Teacher, Principal or Head of School, Assistant Principal, Instructional Coach, Other)
If you gave a response of ‘Other’ to the previous question, please provide a description of your job role in the space provided.	Short answer text field – required
Is your school a Title I school?	Drop down selection or radio buttons: (Options: Yes/No)
Applicant Primary Email	Short answer text field – required
Applicant Primary Telephone Number	Short answer text field – required
Select the School Ambassador Fellowship type you are seeking	Single selection – required Options: Fulltime Fellow, Parttime Fellow, Either
When would you prefer to begin your Fellowship	Single selection – required Options: Fall Cohort (September -March), Spring Cohort (January-June), Either Cohort
Where did you learn about this opportunity (select all that apply)?	Multiple selections – optional Options: Online web search, Current or former Fellow, Fellowship or Department of Education website, School or District communication, national organization, social media, Other
If you gave a response of ‘Other’ to the above question, please briefly describe how you learned about this opportunity	Short answer text field – optional
Section C. Experiences and Achievements	Notes/Description/Reporting Format
1. Educational Publications: Select the response that best reflects your highest level of involvement in writing published or unpublished works related to the topic of education?	Single selections - required Options: (1) Wrote or contributed to one or more books, articles, or educator resources that have been published and featured nationally; (2) Wrote or contributed to one or more books, articles, or resources that were published on a state, or regional level; (3) Wrote or contributed to writing articles, or developing tools and resources that have been featured within my school or district; (4) I have not written any books or articles, or developed any resources that have been published or featured prominently.
Upload one (1) file of no more than 10 pages that supports your response above. Note: Your submitted artifact will be evaluated to ensure it aligns with the response provided. If no supporting artifact is provided, 0 points will be given for this item.	File Upload
2. Presenting and Leading Professional Learning: Select the response that best reflects your highest level of involvement in designing and leading writing published works related to the topic of education? Indicate your highest level of involvement you have had in providing professional development training.	Single selections - required Options:
Upload one (1) file of no more than 5 pages that supports your response above. Note: Your submitted artifact will be evaluated to ensure it aligns with the response provided. If no supporting artifact is provided, 0 points will be given for this item.	File Upload
3. Honors and Recognition Select the response that best reflects the highest honor or recognition, such as a local, state, or national teacher award, that you have received from an educational organization.	Single selections - required Options: (1) Received a national educator recognition award from a recognized national organization (i.e. teacher or principal of the year, teacher hall of fame, etc.); (2) Received a state or regional-level educator recognition award; (3) Received an educator recognition award from your school or district; (4) I have not received any educator recognitions or honors advanced educator credential at the state or national level.
Upload one (1) file of no more than 5 pages that supports your response above. Note: Your submitted artifact will be evaluated to ensure it aligns with the response provided. If no supporting artifact is provided, 0 points will be given for this item.	File Upload
4. Continuing Learning and Advanced Educator Credentials Select the response that reflects the highest level of continuing learning or educator credential you possess.	Single selections - required Options: (1) Possess a national educator credential (from a recognized national organization) that exceeds the minimum job requirements for my role; (2) Possess an advanced state educator credential issued by my State Education Agency that exceeds the minimum job requirements for my role; (3) Possess an advanced degree, certification, or significant amount of post-baccalaureate level coursework (30+ semester hours) at an accredited institution of higher education that exceeds the minimum job requirements for my role; (4) I do not possess an advanced educator credential and have not complete post-baccalaureate coursework that exceeds the minimum job requirements for my role.
Upload one (1) file of no more than 10 pages that supports your response above. Note: Your submitted artifact will be evaluated to ensure it aligns with the response provided. If no supporting artifact is provided, 0 points will be given for this item.	File Upload
5. Involvement in Educational Policy Discussions and Decision-Making Select the response that best reflects the extent to which you have contributed to work or discussions that have led to significant policy decisions.	Single selections - required Options: (1) I have participated in hearings, focus groups, listening sessions, roundtables, meetings, etc., at the national level that have informed educational decisions; (2) I have participated in hearings, focus groups, listening sessions, roundtables, meetings, etc., within my state level that have informed state-level educational decisions; (3) I have participated in hearings, focus groups, listening sessions, roundtables, meetings, etc., that have informed educational decisions within my school district; (4) I not participated in hearings, focus groups, listening sessions, roundtables, meetings, etc., that have informed educational decisions.
Upload one (1) file of no more than 10 pages that supports your response above. Note: Your submitted artifact will be evaluated to ensure it aligns with the response provided. If no supporting artifact is provided, 0 points will be given for this item.	File Upload
Section D. Personal Statement	Notes/Description/Reporting Format
In a video of no more than 5 minutes, provide a compelling case for why you should be selected for the School Ambassador Fellowship. Your personal statement should introduce who you are on a personal and professional level and include discussion about defining moments or experiences in your life that have shaped you into the educator you are. Further, your personal statement should provide examples that demonstrate how you have been an agent of change within your local school district, state, or at the national level. Finally, your personal statement should describe your professional reach and the extent to which you will leverage your existing networks, resources, and abilities to promote the Secretary of Education’s priorities and the Department’s strategic goals and initiatives.	Video link or file upload – required
Section E. Project Abstract	Notes/Description/Reporting Format
In no more than 5,000 characters, identify a significant education-related issue or challenge within your school, district, or the broader educational community and provide a high-level description of your proposed approach for addressing it. In addition to describing your problem and how you would solve it your response should include a description of the root cause(s) for the problem as well as your theory of action and identify the resources you would need to leverage to create sustainable results. Your abstract should identify short, medium, and long-term outcomes and describe how you would measure success. Finally, the abstract should describe how the proposed solution would address one or more of the Secretary of Education’s Supplemental Priorities.	Long text response field (5,000 character max.) - required
Section F. Resume
Provide a copy of your current resume that clearly shows the current school and/or district in which you serve. Your resume should verify that you have worked in the field of P-12 education for at least five years (including the current school year). Although your resume primarily used to verify your eligibility, it is also used as a means of validating your responses in other portions of the application. Thus, applicants are encouraged to ensure their resume aligns with the responses to sections B, C, and D of this application.	File Upload
Section G. Recommendation Request Form
You must provide three (3) letters of recommendation from individuals with whom you have or have had a close working relationship. At least one of your letters of recommendation must be from an employer or current direct supervisor. Your other letters of recommendation may be submitted by colleagues, district officials, former supervisors, or others able to speak to your character as a person, your quality and effectiveness as an educator, your impact on your school community, and importance to the students and families you serve (i.e. a novice teacher you mentored, parent of a student you have taught, staff member you have supervised, etc.). Complete the form below to send a request to each recommender asking them to submit a recommendation on your behalf. You will receive a confirmation email when each recommendation letter has been submitted.	Introductory text explaining the recommendation form requirements.
Title	Short answer text field – required
Recommender First Name	Short answer text field – required
Recommender Last Name	Short answer text field – required
Recommender Email Address	Short answer text field – required
Recommender Type	Single selections - required Options: (1) Current Supervisor/Employer; (2) Former Supervisor/Employer; (3) Colleague; (4) Other recommender.
Note to Recommender (Optional)	Long text response field (1,000 character max.) - Optional
School Ambassador Fellowship Supervisor Recommendation Form
[SAF Applicant Name] has applied to become a member of the U.S. Department of Education’s School Ambassador Fellowship and has identified you as their direct supervisor. The School Ambassador Fellowship is an engagement between the Department and some of our Nation’s top performing P-12 practitioners, which aims to improve educational outcomes for students by leveraging practitioner voice in the creation, dissemination, and evaluation of national education policy. In selecting School Ambassador Fellows, the Department seeks educators who have made demonstrable contributions to Student Learning and who possess elite leadership and communication skills. Please complete the form below to provide insight into the applicant’s professional qualities and their qualifications for membership in the School Ambassador Fellowship. Please note that your response is confidential and will not be visible to the applicant.	Introductory text explaining the purpose of the recommendation form. This form is sent when the applicant selects option (1) ‘Supervisor/Employer’ under the ‘Recommender ‘Type option of Section G.
Name	Short answer text field – required
Position/Title	Short answer text field – required
School Name	Short answer text field – required
School District/Organization	Short answer text field – required
In what capacity are you affiliated with the applicant?	Single selections - required Options: (1) Applicant’s current supervisor; (2) Applicant’s former supervisor (3) Colleague of the applicant; (4) Other affiliation.
If you answered ‘Other’ to the previous question, please provide a brief description in the space provided.	Short answer text field – optional
Rate the extent to which you agree with the following statement: The applicant has made a meaningful impact on student achievement and school success.	Single selections - required Options: (1) Strongly disagree; (2) Disagree; (3) Neither agree or disagree; (4) Agree; (5) Strongly Agree
Rate the extent to which you agree with the following statement: The applicant possesses a record of effective leadership and teamwork amongst peers and other key stakeholders.	Single selections - required Options: (1) Strongly disagree; (2) Disagree; (3) Neither agree or disagree; (4) Agree; (5) Strongly Agree
On a scale of 1-5 with 5 being the highest, rate the extent to which the applicant demonstrates strong written and oral communication.	Single selections - required Options: (1) Strongly disagree; (2) Disagree; (3) Neither agree or disagree; (4) Agree; (5) Strongly Agree
On a scale of 1-5 with 5 being the highest, rate the extent to which the applicant demonstrates the ability to manage complex, multi-faceted projects.	Single selections - required Options: (1) Strongly disagree; (2) Disagree; (3) Neither agree or disagree; (4) Agree; (5) Strongly Agree
On a scale of 1-5 with 5 being the highest, rate the extent to which the applicant has demonstrated the ability to articulate relevant insights to stakeholders regarding education policy, programs, and/or initiatives.	Single selections - required Options: (1) Strongly disagree; (2) Disagree; (3) Neither agree or disagree; (4) Agree; (5) Strongly Agree
In no more than 2500 characters, please provide a statement in support of the applicant’s candidacy for the School Ambassador Fellowship. You are encouraged to elaborate on the ratings provided above and to provide any additional information about the applicants character, skills, and/or unique qualities that you believe should be considered.	Long text response field (2,500 character max.) - required
School Ambassador Fellowship Recommendation Form
[SAF Applicant Name] has applied to become a member of the U.S. Department of Education’s School Ambassador Fellowship and has identified you as someone who can provide insight into their personal and professional character. The School Ambassador Fellowship is an engagement between the Department and some of our Nation’s top performing P-12 practitioners, which aims to improve educational outcomes for students by leveraging practitioner voice in the creation, dissemination, and evaluation of national education policy. In selecting School Ambassador Fellows, the Department seeks educators who have made demonstrable contributions to Student Learning and who possess elite leadership and communication skills. Please complete the form below to provide insight into the applicant’s professional qualities and their qualifications for membership in the School Ambassador Fellowship. Please note that your response is confidential and will not be visible to the applicant.	Introductory text explaining the purpose of the recommendation form. This form is sent when the applicant selects option (1) ‘Supervisor/Employer’ under the ‘Recommender ‘Type option of Section G.
Name	Short answer text field – required
Position/Title	Short answer text field – required
School Name	Short answer text field – required
School District/Organization	Short answer text field – required
In what capacity are you affiliated with the applicant?	Single selections - required Options: (1) Applicant’s current supervisor; (2) Applicant’s former supervisor (3) Colleague of the applicant; (4) Other affiliation.
In no more than 2500 characters, please provide a statement in support of the applicant’s candidacy for the School Ambassador Fellowship. You are encouraged to elaborate on the ratings provided above and to provide any additional information about the applicant's character, skills, and/or unique qualities that you believe should be considered.	Long text response field (2,500 character max.) - required

Hunter, Cynthia

2022-09-09 19:29:00

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Recommendations

Hunter, Cynthia

2022-09-09 19:33:00

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This actually goes to a recommendation form. There isn't a place that asks them to submit a letter of recommendation outside of the "any additional comments" optional text box. All of these questions should be required.

Hunter, Cynthia

2022-09-09 19:35:00

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I can submit to a recommender 2xs, applicant can use his/her own email address as a recommender.

Public Burden Statement

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such collection displays a valid OMB control number.  The valid OMB control number for this information collection is 1810-new.  Public reporting burden for this collection of information is estimated to average 8 hours per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.  The obligation to respond to this collection is voluntary.  If you have any comments concerning the accuracy of the time estimate, suggestions for improving this individual collection, or if you have comments or concerns regarding the status of your individual form, application or survey, please contact [email protected] directly.