West Virginia eLearning for Educators
Online Professional Development
Online Facilitator Application
Submitting your application:
1. Rename this document so the filename includes your last name and date,
e.g., “Smith_Facilitator_App_Dec_2012”
2. E-mail this completed application to dlandin@access.k12.wv.us .
Personal Information
Name:
Street Address:
City/State/Zip:
Home Phone Number:
E-Mail Address:
Preferred Content
Area/Subject to Teach:
Are you currently employed in a West Virginia County School
System? If so, which county?
Name of school where you are currently employed.
Education
Degree:
Year Earned:
Institution:
Certificate Information (A current, valid certificate is required.)
Certificate type:
Grade Levels:
Subject Areas:
West Virginia Department of Education
Donna Landin dlandin@access.k12.wv.us
Teaching & Education Experience
Applicants need not be currently teaching in the classroom; however, a minimum of three years
classroom teaching experience is required to teach online courses. List your educational experience,
beginning with the most recent (add more, if needed):
When (MM/YYYY to MM/YYYY):
District:
School:
Position/Courses Taught:
When (MM/YYYY to MM/YYYY):
District:
School:
Position/Courses Taught:
When (MM/YYYY to MM/YYYY):
District:
School:
Position/Courses Taught:
Short-Answer Questions
1. What type of computer and Internet access do you have at home?
2. Have you taught an online course before? (If yes, give details including the course title,
platform used, and number of students enrolled and completed.)
3. What WVDE eLearning for Educator courses have you completed? (provide the titles,
name of facilitators and dates of your courses)
4. What software or Web 2.0 programs do you use on a regular basis and how do you use
them?
5. In what ways have you integrated technology into your classroom instruction?
6. List three URLs which you have used as part of your classroom instruction, and explain
how you used those sites.
West Virginia Department of Education
Donna Landin dlandin@access.k12.wv.us
7. What factors do you think best foster the successful completion of online courses?
8. Please explain what experience or specific skills you bring to online course facilitation.
References
List three references from whom we can obtain knowledge of your ability, character, and experience.
Please include an immediate supervisor as one of the three references.
Name:
Position:
Phone Number:
E-mail Address:
Name:
Position:
Phone Number:
E-mail Address:
Name:
Position:
Phone Number:
E-mail Address:
Thank you for applying to teach for West Virginia eLearning for Educators Online Professional
Development. Facilitators will be selected based upon experience, qualifications, recommendations, and
course need. Selected applicants will be hired on a contract basis. Educators who are currently under
contract must teach their online course outside the regular school day. Retired and at-home educators
who have a current West Virginia teaching certificate are also encouraged to apply.
West Virginia Department of Education
Donna Landin dlandin@access.k12.wv.us