Any active member interested in being considered by the Certification Committee to serve as an instructor of a MMTCTA sponsored workshop must meet the following criteria and procedures:
SPECIAL CONDITION: The MMTCTA Executive Committee reserves the right to waive the above list of criteria/procedures for new instructors, if by a unanimous vote of the MMTCTA Executive Committee, an instructor is approved to instruct a MMTCTA sponsored workshop based on prior education, work experience, recommendations, and teaching experience; all deemed necessary to be in accordance with the MMTCTA workshop standards.
NOTE: Student instructors will
be reimbursed for expenses, but will not be eligible for an honorarium until
they are an approved Instructor.
| NAME: ___________________________________________________________ |
ADDRESS:_________________________________________________________ __________________________________________________________________ |
TELEPHONE #_________________ FAX #____________________ |
POSITION_____________________# YEARS POSITION HELD:________ |
MUNICIPALITY_______________________________________________ |
1. Are you an active member of MMTCTA? Yes No |
2. MMTCTA Certification/Date received: _______________________ |
3. Prior municipal experience: __________________________________________ _________________________________________________________________ |
4. Prior work experience______________________________________________ _________________________________________________________________ |
5. Education: ______________________________________________________ ________________________________________________________________ |
6. Prior teaching experience: __________________________________________ ________________________________________________________________ |
7. Please list the courses you are interested in teaching: _______________________ _________________________________________________________________ |
8. What is your availability and/or limitations on your schedule (Are there days which you are not available?) ____________________________________________________ __________________________________________________________________ |
9. Please provide a summary of why you would like to be considered as a student instructor for MMTCTA. (Use back of page, if necessary) ______________________ __________________________________________________________________ |
Signature__________________________________ DATE___________________ |
Return to: MMA/Joan Kiszely
60 Community Drive
Augusta, ME 04330