Program Overview

Application for Participation

If you are interested in taking advantage of this exciting opportunity, we encourage you to complete an application to the Academy for Associate Faculty.

Applicant's Name:

Email Address:

College of Employment:

Business or Work Affiliation:

Your Title or Position There:

Your Preferred Mailing Address:


Your Telephone Numbers:
home		work

Total Number Years of Teaching Experience:

Date of Employment at College:

Total Number of Courses Taught:

Please List Each Course Taught:

Course	No. of Times Taught

Have you ever taught at any other institutions of higher learning?
	Yes	No

Educational Background Information

Highest Degree Earned:

Major Field of Study:

Teaching Field(s):

Briefly explain why you would like to participate in this academy, and what you hope to obtain from this experience.

>>	Program Philosophy & Mission
>>	Program Description
>>	Selection Criteria
>>	Training Incentives
>>	Application for Participation

Fiscal Agent: Northeast Texas Community College P.O. Box 1307 Mt. Pleasant, TX 75456 Tel: 903.572.1911 Fax: 903.572.6712

This project is funded by the Carl D. Perkins Vocational Act though the Texas Higher Education Coordinating Board
under the title of Academy for Part-Time Teachers.