Personal InformationThis field is hidden when viewing the formDate Submitted Month Day Year Name(Required) First Last Email(Required) School District(Required)Preferred Mailing Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Consent and SignatureScope of Services The District Lead agrees to provide services to support the Early Childhood Registered Teacher Apprentice Program (ECE RTAP). The responsibilities of the District Lead may include, but are not limited to: Program Communication and Coordination Serving as the primary point of contact with the ECE RTAP team and the Department of Education (DOE). Keeping district personnel informed about program standards, competencies, and updates. Participating in monthly district lead meetings to discuss program progress and challenges. Responding to weekly program emails from the ECE RTAP team. Recruitment and Placement Identifying Career and Technical Education (CTE) teachers qualified to deliver ECE content. Support the process of securing appropriate placement facilities for apprentices with qualified mentor teachers while maintaining appropriate student-to-mentor ratios. Assisting in recruiting students for the program and scheduling informational meetings with potential apprentices. Student Support Supporting the enrollment process and ensuring apprentices meet program requirements. Ensuring ECE RTAP is listed in the district's curriculum guide/course handbook. Distributing materials to students as needed, such as gas cards. Program Monitoring and Reporting Monitoring enrolled apprentices to ensure they are on track for success. Keeping the ECE RTAP team informed of enrollment or personnel changes. Helping schedule and participating in district and apprenticeship orientation meetings. Additional Support Participating in DOE office hours as available. Supporting program operations and alignment with the Next Level Program of Study. Compensation The District Lead will receive a stipend of $2929 per school year paid $1464.50 in January and June of the calendar year, which will be paid directly to the individual and not their employer. This stipend is contingent upon the successful performance of the roles and responsibilities outlined above, some of which may require work outside the standard contract day. Terms and Conditions Independent Contractor The District Lead is engaged as an independent contractor and not as an employee of CIESC. This Agreement does not establish any employer-employee relationship between the parties. Duration of Agreement This Agreement is effective from date signed and will remain in effect until notified of withdrawal from the program unless terminated earlier by either party with written notice. Confidentiality The District Lead agrees to maintain confidentiality of any proprietary or sensitive information obtained during the performance of this Agreement. Termination Either party may terminate this Agreement with a written 30-day notice. Any stipend payments may be prorated based on work completed up to the termination date. Governing Law This Agreement shall be governed by the laws of the State of Indiana. Consent(Required) I have read and agree to all the above.1099 Consent(Required) I understand I will receive a 1099 tax form for this payment and will be responsible for reporting this income on my annual IRS tax return.Signature(Required)Please use your touchscreen or mouse to draw your signature below.
