Teacher Initial Interest Form
Thank you for your interest in this study on re-imagining teacher preparation through disability-centered, culturally sustaining pedagogies! Please fill out the following form to the best of your knowledge. If you have any questions please contact disabilitycenteredcsp@gmail.com
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Name (First, Last) *
Email Address *
Do you attend one of these three institutions? *
What type of school do you work at? *
What is the name of your school district and school (ex: Garfield Elementary, Oakland Unified School District). If you are not working in a school, please put N/A. *
What is your CURRENT role in this district? Check all that apply. *
Required
Describe approximately how many students at your school are identified as having a disability (have an Individualized Education Plan). You can estimate. *
Approximately how many students at your school are identified as English Language Learners (ELLs)? *
What is the approximate racial breakdown at your school site? *
In 100-150 words, describe what the term disability means to you. *
Briefly, in 1-2 sentences, describe what you know about accessibility. *
In 100-150 words, describe what the words "culturally sustaining" mean to you. *
In 100-150 words, describe what the word "intersectionality" means to you. *
Do you see yourself as an educator for disability and racial justice?  If so, how?  If not, why not? (150 words or less) *
Can you commit to full participation in this project (attending every engagement virtual session, community-activist workshop, and focus group session; attending the retreat) as well as completing all required activities? *
What kinds of supports would be helpful to you to participate in this series? *
Is there anything else we should know about you that you think would be beneficial? *
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