LEA Representative Contact Information / Committees

Hello Everyone,

 

I am updating my files and need for you to complete the following items.  The information will be used for my correspondence with you as a member of the Collaborative.  Thanks.

Ralph

1
Enter your information in the following fields.  Occasionally emergencies arise and I may need to contact you.  If you feel uncomfortable providing any of the items, please feel free to omit.
Last Name, First Name MI
Office Phone
Home Phone
Cell Phone
Email 1
Email 2
Birth Date
2

Do you plan to be the Collaborative Representative for your district next year?  If not, who will be your replacement?

Replacement's Name
3

Do you have someone in your district who can serve as an alternate to the Collaborative in the event you cannot attend one of our meetings or other functions?  If so, please enter that person's name in the space provided

Alternate's Name
4
Select the LEA you represent as a member of the Collaborative.  If you are not an LEA representative, but are a partner, choose "Other" and fill in the name of your organization.
Bertie
Camden
Edenton-Chowan
Edgecombe
Gates
Halifax
Hertford
Martin
Northampton
Perquimans
Roanoke Rapids
Tyrrell
Warren
Washington
Weldon
Other, please specify
5
Enter the following information for your LEA (or other organization).
Superintendent's Name
Mailing Address
Physical Address
City/Town
State
Zip
Phone
Fax
Email
6

As we plan for the 2010-11 school year, I believe we can be even more productive if we continue to utilize a committee structure as we implement our initiatives.  Please indicate if you think each listed committee is one we need for the comping year.

1
Yes
2
No
3
Not Sure
Beginning Teacher Welcome Packet
Budget/Finance
Director's Evaluation
Grants
Principals' Evaluation Project
Spring Conference
Support Coach Project
Surveys
Teachers' Evaluation Project
Virtual Collaboration -- PLCs
Web Redesign
7

For the committees you selected as "Yes" in the previous question, please indicate your first, second, and third choices with which you would be interested in working for the upcoming school year.  You may also select an alternate.  I will use these results to design the committee structure.

 

If you select a committee and later wish to remove that choice, click the button in the "Unselect" column.

1
First
2
Second
3
Third
4
Alternate
Unselect
 
Beginning Teacher Welcome Packet
Budget/Finance
Director's Evaluation
Grants
Principals' Evaluation Project
Spring Conference
Support Coach Project
Surveys
Teachers' Evaluation Project
Virtual Collaboration -- PLCs
Web Redesign
8

Please use the space below to enter questions or comments regarding this survey.

9

In your opinion, was this survey an effective means of gathering this information?

Additional Comment