2022 Judicial Institute Application - Eastern District of Washington

Name *

Home Mailing Address (Street Address/PO Box Number) *

City *

State *

Zip *

Work Phone

Home Phone

Cell Phone

Email Address *

Name of School *

School District *

Mailing Address (Street Address/PO Box Number) *

City *

State *

Zip *

Current Teaching Assignment *

Washington Teaching License * #

If selected for participation, will your teaching schedule allow for you to participate uninterrupted for the full two-day agenda? *

Yes

Please secure a statement of support from your immediate supervisor or other school administrator. *

Statement of intent *

Provide a brief statement of intent - no more than 300 words - as to how you will: (1) use the Eastern District of Washington Judicial Institute experience to enhance your curriculum/teaching assignment; and (2) share your experience with teaching colleagues.