BUTLER COUNTY PERFORMANCE BASED
INCENTIVE PROGRAM
Butler County Board of Education
211 School Highlands Road
Greenville, AL 36037-1833
Telephone: 334-382-2665
Fax:
334-382-8607
Litta.norris@butlerco.k12.al.us
MASTER TEACHER APPLICATION
Name_____________________________________________________________________________________
(Last)
(First)
(Middle)
(Maiden)
Date of Application____________________________ Social Security Number___________________________
Present Address_____________________________________________________________________________
Permanent Address__________________________________________________________________________
Present Telephone Number ( )____________________Permanent Telephone Number( )_________________
CURRENT POSITION
School Site _____________________________________
Subject _______________________
Grade Level ________
Number of years serving as a mentor teacher_______
EDUCATIONAL AND PROFESSIONAL TRAINING
(List below any school, college, or university you have attended. List in chronological order)
College/University/
Trade School
City/State
Dates Attended
From
To
Major/Program
Degree/
Certificate
PREVIOUS TEACHING/ADMINISTRATIVE EXPERIENCE
(Include all full time teaching experience in chronological order – attach an additional sheet if necessary. Do not include substitute teaching)
Dates
From
To
Employer and Address
Telephone
Number
Supervisor
Job Title
Grade/Subject
Application Questions
Briefly respond to each question below on a separate sheet of paper.
1.
2.
3.
4.
5.
6.
7.
Explain how you align your teaching goals with school goals and content standards.
Describe activities you use to ensure students are actively engaged in the lessons you teach.
How important do you think it is for teachers to continuously update their instructional skills?
Describe the qualities and characteristics of an effective campus instructional coach.
How would you approach working with a teacher who did not want your help?
How would you handle negative attitudes among staff?
What skills do you possess that you believe will make you a successful master teacher/instructional coach?
REFERENCES
List the individuals who will be submitting the recommendation checklist on your behalf.
NAME
POSITION
SCHOOL
CERTIFICATION
State
Areas of Certification
Dates of Expiration
By my signature, I certify, to the best of my knowledge, that all information contained in this application is true and represents me
accurately. I understand that falsification of information on this application constitutes grounds for dismissal.
I authorize the Butler County School System to conduct an investigation of personal, educational, vocational, and employment
history. I further authorize any former employer, person, firm, corporation, educational institution, or government to provide the
Butler County School System with information regarding my performance, character, and general reputation. I discharge the Butler
County School System and those who provide information from any liability as a result of furnishing this information .
_________________________________
___________________________________
_____________________
Print Name
Signature
Date
It is the policy of the Butler County Board of Education that no person be excluded from participation in, be denied the benefits of, or be
subjected to discrimination in any program or activity, on the basis of race, color, disability, sex, religion, national origin/ethnic group or age.
The Butler County Board of Education is an equal employment opportunity employer. The Equity Coordinators are the Administrative
Assistant for Student Services (Section 504 and ADA) and the Assistant Superintendent (Titile VI and IX). Their offices are located at the
system Central Office, 211 School Highlands Road, Greenville, AL 36037-1833, Telephone (334) 382-2665.