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Instructor Application

Secondary Instructor Approval Form

All required information is marked with an asterisk. After you submit this form, a confirmation email will be sent to you to keep for your records.

Please Note: Approval to serve as the instructor of record for Professional Development courses does not extend beyond these types of classes. You are being approved as an instructor for K-12 Teacher Professional Development courses only.


  • COURSE INFORMATION

  • We must have both the Instructor Application and Course Setup Application in order to process the request. Please remember to submit a Course Setup Application for this course, if you have not done so already.
  • CONTACT INFORMATION

  • EDUCATION

  • PROFESSIONAL EXPERIENCE

    Please list your work experience in chronological order, starting with your present position.