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** Registration Form **
Please complete this brief registration from in order for facilitators to better prepare for each workshop. PENC workshops are offered free to all NC educators. For specific information about these workshops, please contact Dr. Glennda McKeithan (
gkmckeit@ncsu.edu
).
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2019-20 ** National Board Support Workshops
Workshop Date/Format Choice
March 14, 2020 – In Person - Eastern Wayne High School, Goldsboro, NC – Initial | Renewal
April 4, 2020 – In Person - Greensboro College School of Education, Greensboro, NC – Initial | Renewal
Last Name
*
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First Name
*
Your answer
School/Business
Your answer
Primary Email address
*
Your answer
Secondary Email address (must have 2 different emails)
*
Your answer
Phone number
*
Your answer
School/Business (name/address)
Your answer
PENC Membership Status
*
PENC member
Non-member
I am interested in learning more about membership benefits
I have attended a prior PENC/NBPTS workshop
Other:
Required
NBPTS status
*
Current Initial Licensure Candidate
Future Initial Licensure Candidate
Current Renewal Candidate (already NBPTS)
Future Renewal Candidate (already NBPTS)
Other:
Required
Specific Area(s) of Interest
Initial Component 1
Initial Component 2
Initial Component 3
Initial Component 4
Renewal Component 1
Renewal Component 2
Renewal Componet 3
Candidate progress
have ideas
have drafts
beginning process
seeking information
Clear selection
NBPTS Certificate
*
Art (EMC or EAYA)
Career & Tech Ed (EAYA)
English as a New Language (EMS or EAYA)
English Language Arts (EA or AYA)
Exceptional Needs Generalist (ECYA)
Generalist (EC or MC)
Health Ed (EAYA)
Library Media (ECYA)
Literacy-Reading (EMC)
Math (EA or AYA)
Music (EMC or EAYA)
PE (EMC or EAYA)
School Counseling (ECYA)
Science (EA or AYA)
Social Studies (EA or AYA)
World Languages (EAYA)
Other:
Required
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