WCTP Application, University of MS

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2021-2022 National Board Candidate Support

Last Name *

First Name (Please, indicate if you go by your middle name) *

Email Address (We will communicate via the email you provide) *

Phone Number (Please indicate if you wish not to be included in our Remind Texts.) *

Academic Year

2021-2022

Clear selection

National Board Certificate Area

Components you wish to complete this year. *

Component 1

Component 2

Component 3

Component 4

Required

Candidate Status *

NBPTS Candidate ID # (8 digits) *

How did you hear about us? *

Social Media

Friend

School/District

Other:

Required

School Name and District *

Teaching Experience (Number of years) *

County *

Preferred Type of Mentoring (Face to Face mentoring is available for most certificate areas in Grenada, Oxford, DeSoto, Tupelo, and Madison County). *Please note due to COVID, some Face to Face mentoring may be moved to online. *

Face to Face

Online Mentoring w/Face to Face Zoom Meeting

If applicable, pay your annual non-refundable WCTP enrollment fee of $100. Once you submit this form, a link will be provided in your confirmation message. *

Enrollment Fee Deadlines: November 1 for summer & fall candidates, February 28 for candidates that join after November 1.

I qualify for a scholarship. I teach in one of the 13 identified counties.

I qualify for a scholarship. I am currently enrolled in the University of Mississippi's Specialist program and will be completing National Boards as Independent Study. (Letter from UM advisor is req'd)

I qualify for a scholarship. I deferred a component last year due to COVID-19

I qualify for a scholarship. I am an advanced candidate and did not certify.

I do not qualify for a scholarship and will pay my enrollment fee by the noted date.

Required

WCTP Participation Term 1 (All participation terms must be met prior to receiving candidate support) *

I have made my "Good Faith" down payment on a component

Required

WCTP Participation Term 2 (All participation terms must be met prior to receiving candidate support) *

I have released my information to 3rd Party (NB, MDE, and WCTP)

WCTP Participation Term 3(All participation terms must be met prior to receiving candidate support) The NB registration fee has also been waived for the candidates that deferred or took an extension due to COVID. *

I have paid the $75 National Board Registration Fee

WCTP Participation Term 4 (All participation terms must be met prior to receiving candidate support) *

I understand that I can only participate in one World Class Teaching Program. I choose UM WCTP.

Thank you for completing our application. We look forward to working with you on your certification journey.

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