CELA Educator Advisory Group Application Form

The purpose of the Educator Advisory Group is to provide the CELA staff and board information and insight from users and potential users of our services. The Group will be provided with the opportunity to aid in strengthening CELA services and to inform the strategic and technological direction of the organization.

Appointments to the Advisory Group is for a two year term. Please read the terms of reference for more information.

Criteria for serving on the group include:

Willingness and ability to commit to the necessary time and effort required to contribute meaningfully to the group;
Commitment and interest in the development of CELA services for students across Canada and with different print disabilities, with that interest informed by personal or professional experience;
Skills and experience related to previous work with student support, educational initiatives or community-based projects supporting those with print disabilities;

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* 1. Name:

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* 2. Title:

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* 3. School or organization:

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* 4. Email:

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* 5. Province or Territory:

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* 6. Which level of education do you teach or support (select all that apply)?

Elementary

Secondary

Postsecondary

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* 7. What type of education system/method do you represent (select all that apply):

Public

Publically-funded religious schools

Private

Homeschool

Service supporting students, e.g. accessible technology tutor

Organization or advocacy group

Other (please specify)

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* 8. Rank the types of print disabilities your students represent.

	Most	Some	Very few	None
Learning disabilities	Learning disabilities Most	Learning disabilities Some	Learning disabilities Very few	Learning disabilities None
Physical (inability to hold a book or difficulty turning pages)	Physical (inability to hold a book or difficulty turning pages) Most	Physical (inability to hold a book or difficulty turning pages) Some	Physical (inability to hold a book or difficulty turning pages) Very few	Physical (inability to hold a book or difficulty turning pages) None
Visual	Visual Most	Visual Some	Visual Very few	Visual None

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* 9. Which accessible reading service(s) are you using?

CELA

Bookshare

Both CELA and Bookshare

Neither Learn about CELA's Educator Access Program

Other (please specify)

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* 10. Please indicate your preferred time of day for the Group meetings (select all that apply). Discussions will usually take 1 hour.

Morning

Early afternoon (1:00 - 3:00)

Late afternoon (3:30 - 5:00)

Evening

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* 11. Please provide a short statement on why you are interested in joining this group.

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* 12. Are there specific topics you would like discussed?

Thank you for applying to be part of CELA’s Educator Advisory Group. Your application will be forwarded to staff and we will be in touch with you soon. Please select the Done button below to complete the form.