Support Provider Application
Name: (Last, First, MI)
School Site:
Phone:
Grade(s)/Subject(s):
Email Address:
Criteria:
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Candidate must have at least 2 years of contracted teaching experience in IUSD
Candidate must hold a current CA Clear Credential
Candidate must be able to attend all required meetings and trainings
Candidate must have a positive recommendation from district or site administration
Candidate must visit and communicate with new teacher(s) on a regular basis
Teaching Experience: (Please Print)
Dates
School Site
Content Areas
School/District Responsibilities: (Please List)
Grade(s)
i.e. SIP, PAR, student council advisor, sports coach, etc.
Educational Information (Please Print)
Institution
G:\HR-Share\Induction\Forms\2015-2016
Employing District
Degree/Certificate
Major/Minor
Support Provider Application
Answer the following questions briefly, but thoughtfully. Use additional paper if necessary.
1. What are your three most critical strengths as a teacher?
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2. Describe your experiences, if any, in supervision of student teachers, team leadership,
mentoring, or other similar roles.
3. Describe your familiarity and/or experience with the tools of reflective practices that might
include cognitive coaching, peer observations, reflective writing, etc.
4. How do you stay current on effective instructional practices at your grade level and/or
content area?
5. What is your familiarity with content standards and frameworks in the subject matter most
significant for your grade level or classes you teach? Describe your experiences learning
and using the standards.
G:\HR-Share\Induction\Forms\2015-2016
Support Provider Application
6. How do you self-assess and reflect on your professional growth?
7. Describe what it is about you personally and professionally that will make you effective in the
role of Support Provider.
Applicant’s Statement
I would like to participate in Induction as a Support Provider in the Irvine Unified School District. I
understand the roles and expectations of Support Providers and I agree to meet and fulfill them.
Signature:
G:\HR-Share\Induction\Forms\2015-2016
Date: