1 st Stage: New ITPC Program Application Packet

Transcription

1 1 st Stage: New ITPC Program Application Packet 1. Training Program and Institution Details for Certification: Institution Name:!"$%&'()+,-+.(/01+&23 Program Name: Program s Webpage URL Address Link: 4.(+&"567%3&""5-%&$8%' /((9:;;<<<=.',=%2.;1%3&""5 Program s Complete Mailing Address: 4.(+&"567%3&""5-%&$8%'!"$%&'()+,-+.(/01+&23 >?@?A=0+<1%&B$%=C7DEF?? 43G93C07HHI?@JK>@@ Name(s) of the Primary & Other Contact Person(s) & their Position Title(s): Application Agreement: As the primary Contact for the program submitting this application, you and your program agree to continue to follow the guidelines that you have submitted in this application packet. (Please list only permanent employee(s) to facilitate future communication - no grad. assistants, temps, etc.) 1)! Dr. _ Mr. _ Ms. : L3(&83M3/%&CN&%8(+& 2) _ Dr.! Mr. _ Ms. : O3)"%O1'+"CB'''(3"(N&%8(+&!" _ Dr.! Mr. _ Ms. : 4&+)M11%&CB832%G8-.99+&(P++&2"3(+& Address(s): L3(&83M3/%&: LM3/%&Q.',=%2. O3)"%O1'+": OO1'+"Q.',=%2. $%&'(')+',-%.&+:RE%(3"8+.&(Q.',=%2. Voice Phone : STFHUVW>J?WFH Fax Phone : STFHUVW>JH>HF 2. Optional questions used only for statistics & demographic research by other CRLA members: Primary Contact is a CRLA Member:! Yes No (Personal or Institutional CRLA membership is not required for participation in the ITPC program) Type of Institution: _ 1 yr _ 2 yr Fr-Sph _ 3-4 yr Jr-Sr! 4 yr Fr-Sr _ Bus _ Other Funding Source:! Public _ Private _ Business _ Other (specify): 3. Certification Level(s) requested using this application: (Mark an X for each level requested.) (Fees can be combined if you are also applying now to add this level(s) to your current certification) X Level 1 / Certified Tutor (1 year certification) 4. Non-refundable Fee for application(s) for the SAME PROGRAM, submitted together (effective 7/1/09): (Fees can be combined if you re now also submitting another appl. to add a new level(s) to your current certification.) If submitting an online application is a problem, contact Rick Sheets at: rick.sheets@crla.net. Fee schedule for online and paper applications is also listed on the Instructions pages of this application. (Always verify current fees on our website.) 5. Application Packet file to ONLY : itpc@crla.net (only address that can receive large files) [Note: Name your Subject: field using this format. These Program Details expedite processing.] Country,StateAbbrev,InstName,Campus,City,PrgrmName-Levels,N(new)/RR(renew)/RC(recert),part 1 (pt1,pt2,!) Sample: USA, ZZ, Sample U., Zville Campus, Zville, Learning Assistance Center L123, N, pt 1 Page 1 1 st Stage: New/Rejoin ITPC Program Certification Application Packet Rev. 3/6/2010

2 6. BRIEF PROGRAM OVERVIEW FOR THE LEVELS REQUESTED ON THIS APPLICATION a) Program History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b) Program Objectives: ]%8&.(C/&%C(&3"C'.99+&(C3"2&%(3"^.31,%2'(.2%"('3'(.(+&' B'''('(.2%"('(+Y%8+G%8+",2%"(C'%1,J2&%8(%2C1,%J1+"51%3&"%&' X,,%&3$3&%()+,1%3&""5'.99+&(+9(+"' ]%9&%'%"(3"38($%8+"8%&",+&'(.2%"('_3832%G8<%11JY%"5 P&%3(%3"3(G+'9/%&%+,G.(.31&%'9%8(3"2(&.'(,+&'(.2%"(' L&+$2%'(.2%"('<(/388.&3(%C&%1%$3"(C3"2399&+9&3(%",+&G3(+"3"2&%,%&&31' P+"(".311)&%$%<9+18%'3"29&38(8%'(+%"'.&%(/3('(.2%"('3&%399&+9&3(%1)'%&$%2 M3"(3"3""$("5C/%19,.1C3"2399&+38/3Y1%G3""%& M3[%%$%&)%,,+&((+(.&"%38/'(.3(+""(+1%3&""5%`9%&%"8%',+&(.(+&'C'(.2%"(J%G91+)%%'C3"2'(.2%"(' ]%,%& '(.2%"(' 3' "%8%''3&) (+ 399&+9&3(%."$%&'() &%'+.&8%',+& (/% 9.&9+'% +, %"/3"8"5 (/%& %2.83(+"31 %`9%&%"8% Page 2 1 st Stage: New/Rejoin ITPC Program Certification Application Packet Rev. 3/6/2010

3 c) Reporting Lines: d) Sources of Funding: 4.(+&"567%3&""5-%&$8%'3"".31Y.25%(''.99+&(%29&G3&1)Y)'(3(%311+83(+"'<(/3'G3119+&(+"8+G"5,&+G (/%83G9.'_-(.2%"(4%8/"+1+5)0%%(+,."27%3&""5P+GG+"'X"1"%= e) Services and Students Served: -%&$8%'+,,%&%2Y)4.(+&"567%3&""5-%&$8%'&%,1%8((/%2$%&'%"%%2'+,(/%5&32.3(%3"2."2%&5&32.3(%'(.2%"( Y+2)C</1%'.99+&("5(/%!"$%&'()+,-+.(/01+&23_'5+31'+,9&+G+("5G938(,.1&%'%3&8/C3832%G8%`8%11%"8%3"2 '(.2%"('.88%''=4/% &%9&%'%"('(/%9&+5&3G'(/3(3&%'.99+&(%2(/&+.5/(/%2%93&(G%"((+G%%((/%"%%2'+, (''(.2%"(':SFU-(.2)-G3&(O+&['/+9'CS?U7%3&""5-.99+&(P+.&'%'CSHU4.(+&"53"2S>U(/%O&("5P%"(%&= Page 3 1 st Stage: New/Rejoin ITPC Program Certification Application Packet Rev. 3/6/2010

4 4.(+&"5P%"(%&: 7+83(%2+"(/%'%8+"2,1++&+,(/%!-043G937Y&3&)C(/%4.(+&31P%"(%&+,,%&'3<2%&3"5%+,9%%&J(.(+&"5,&+G 9%&+282&+9J"+9(+"'(++"5+"5'G3115&+.9'C3"2"81.2"5<%%[1)399+"(G%"('=L%%&(.(+&'3&%%(/%&.99%&1%$%1."2%&5&32.3(%+&5&32.3(%1%$%1'(.2%"('=E%1+<3&%(/%a8%"(%&'b,&+G</8/'(.2%"('83"&%8%$%(.(+&"53'''(3"8% M3(/P%"(%& / B8+113Y+&3($%2&+9"8%"(%&'.99+&("5P+11%5%B15%Y&3CL&%JP318.1.'C0"(%M3(/C3"2M3(/,+&7Y%&31B&(' / -(3,,%2Y)9%%&(.(+&',&+G(/%M3(/2%93&(G%"(C4%38/"5B'''(3"('3"247-(.(+&' P/%G'(&)P%"(%& / B8+113Y+&3($%2&+9"8%"(%&'.99+&("5P/%G'(&)DCDDC3"2P/%G'(&),+&4+23) / -(3,,%2Y)4%38/"5B'''(3"(',&+G(/%P/%G'(&)N%93&(G%"(3"29%%&(.(+&',&+G47- -4AMP%"(%& / B8+113Y+&3($%C5&3"(J,."2%28%"(%&'.99+&("5P318.1.'DCDDC6DDDCE.'"%''P318.1.'C7,%-8%"8%P318.1.'CL/)'8'C P/%G'(&)C3"2E+1+5) / -(3,,%2Y)9%%&(.(+&'3"24%38/"5B'''(3"(' O&("5P%"(%&: 7+83(%2+"(/%43G937Y&3&)P+GG+"',1++&C(/%O&("5P%"(%&+,,%&'(.(+&"59&G3&1)+"3"399+"(G%"(Y3''= X9%&3(%2"8+"\."8(+"<(/(/%A"51'/N%93&(G%"(CO&("5P+"'.1(3"('3&%5&32.3(%'(.2%"('</+/%19'(.2%"(' 5%"%&3(%C+&53"Z%C3"22%$%1+92%3',+&3''5"%2939%&'=O&("58+"'.1(3"('/%19(+2%"(,)9."8(.3(+"3"2 5&3GG3&%&&+&'C3'<%113'(%38/'(.2%"('/+<(+9&++,&%32C2+8.G%"('%8+"23&)'+.&8%'C3"2322&%''3/+'(+,+(/%& <&("5J&%13(%2''.%'=c+<%$%&C<&("5(.(+&'2+"+(%2(+&9&++,&%32'(.2%"('_939%&'=4/%5+31'(+9&+$2%^.31() 3'''(3"8%C(++1'C3"2&%'+.&8%'(+/%19'(.2%"('Y%8+G%8+",2%"(C"2%9%"2%"(<&(%&'= -(.2)-G3&(O+&['/+9': X&53"Z%23"28++&2"3(%2Y)47-C(/%-(.2)-G3&(O+&['/+9'%&%''38+113Y+&3($%%,,+&(Y)'%$%&312%93&(G%"('+" (/%43G93P3G9.'"81.2"547-C(/%43G937Y&3&)C4/%P+."'%1"5P%"(%&Cc+.'"56]%'2%"(31A2.83(+"C3G+"5 +(/%&'=B'8/%2.1%+,<+&['/+9''8&%3(%23((/%+"'%(+,%38/'%G%'(%&3"29+'(%2+"(/%47-<%Y'(%=B11!-0 '(.2%"('3&%%15Y1%(+3((%"23"2"+&%5'(&3(+"'&%^.&%2=4+98'"81.2%4%'(43["5C4%'(B"`%()C4G% M3"35%G%"(CM%G+&)3"2-(.2)-[11'C4%`(Y++[-(&3(%5%'CdLBP318.13(+"C%(8= 7%3&""5-.99+&(P+.&'%': 0&+G,&'(J)%3&'(.2%"('(+(/+'%9&%93&"5,+&5&32.3(%'8/++1(%'("5C1%3&""5'.99+&(8+.&'%'3&%3$313Y1%(+/%19 '(.2%"('3''%''(/%G'%1$%'3'1%3&"%&'3"22%$%1+93<2%&3"5%+,'(&3(%5%'(+G9&+$%'(.2)'[11'C(G%G3"35%G%"(C &%32"5'(&3(%5%'C3"2<&("5'[11'=P+.&'%'+,,%&"5'"81.2%: ]AB?I@> -(&3(%587%3&""5 FP&%2( ]ABFI@K B2$3"8%27%3&""5-)'(%G'?P&%2(' ]AB?F@K P&(831]%32"53"2O&("5 HP&%2('eG%%('-(3(%+,01+&23"(%"'$%<&("55&32.3(+"&%^.&%G%"( ]ABF?@K B2$3"8%2]%32"5 HP&%2(' ]ABFH@K ]%32"573Y FP&%2( AfPFFH@ DG9&+$"5P+11%5%O&("5 HP&%2(' Page 4 1 st Stage: New/Rejoin ITPC Program Certification Application Packet Rev. 3/6/2010

5 f) Program Location and Facility: 4.(+&"567%3&""5-%&$8%''93&(+,(/%7Y&3&)_'7%3&""5P+GG+"'3"2'1+83(%2+"(/%'%8+"2,1++&=4/%'938% 13Y%1%2a4.(+&"53"27%3&""5-%&$8%'bY%1+<'.(1Z%2(+/+.'%32G"'(&3($%9%&'+""%1C&%8%9(+"3&%3C 5&32.3(%3'''(3"('C'(+&35%C3"2&++G'(/3('.99+&('G3115&+.9(.(+&"5'%''+"'=4/%'938%13Y%1%2aM3(/ 4.(+&"5P+G9.(%&73Yb'</%&%+.&M3(/P%"(%&'1+83(%23"2(/%-3G.%1g=0.'(.[\3"M%G+&314%8/"+1+5)73Y '</%&%(/%$3'(G3\+&()+,(.(+&(&3""5(3[%'9138%= g) Training Guidelines: 4.(+&4&3""53(!-0'Y3'%2+"(/%8+"8%9('+,8+"'(&.8($'GC"^.&)CG%(38+5"(+"3"238($%1%3&""5=h.'(3' (.(+&'3&%(&3"%2(+'.99+&('%1,J2&%8(+""1%3&""53"2.(1Z%38($%1%3&""53"2"^.&)(%8/"^.%'C(/%(.(+& (&3""59&+8%''G+2%1'(/3('3G%9/1+'+9/)=4/'8.&&8.1.G'2%'5"%2(+&%9&%'%"((/%8+"8%9('3"22%'8&Y% (/%9+"('3"2'[11'(/3(3&%2%%G%2G9+&(3"(,+&(.(+&'(+2%$%1+9= 4/'9&+8%'''8+"(".%23'93&(+,(/%47-+"5+"5(.(+&%$31.3(+"9&+8%''%38/'%G%'(%&=4/'"$+1$%'%38/(.(+& 8+G91%("53,+&G31'%1,J3''%''G%"(%38/'%G%'(%&C</8/',+11+<%2Y)3G%%("5<(/(/%B'''(3"(N&%8(+&+& B832%G8-.99+&(P++&2"3(+&(+&%$%<93'(5+31'C'%1,J3''%''G%"(&%'.1('C'(.2%"(3''%''G%"(&%9+&('C3"2(+ %'(3Y1'/"%<5+31',+&(/%"%`('%G%'(%&= h) How You Generally Conduct Your Training (group size, meeting frequency/length, type of presentation): 4&3""5(+G%%(7%$%1F8%&(,83(+"(3[%'9138%+$%&(/%8+.&'%+,,+.&<%%['2.&"5(/&%%/+.&'%''+"'2.&"5(/% Y%5"""5+,%38/'%G%'(%&=4/%(&3""5'%''+"'3&%,381(3(%2Y)(/%2&%8(+&C(/%3'''(3"(2&%8(+&+&3832%G8 '.99+&(8++&2"3(+&+,4.(+&"567%3&""5-%&$8%'2%9%"2"5+"(/%8+"(%"(3"2(/%32G"'(&3($%9%&'+""%1_' %`9%&('%S'U=4/%&%'3""(%"(+"31%,,+&((+"8+&9+&3(%+99+&(."(%',+&"2$2.31C'G311J3"213&5%J5&+.9<+&[ (/&+.5/+.((/%(.(+&(&3""58.&&8.1.G= Page 5 1 st Stage: New/Rejoin ITPC Program Certification Application Packet Rev. 3/6/2010

6 7.1 LEVEL I: TOPICS, MATERIALS, AND DOCUMENTATION (SUMMARY CHART) Topic!"$%&'($)+N%,"(+" +,(.(+&"53"2(.(+& &%'9+"'Y1(%'!"$%&'($),+B2.1( 1%3&"%&';1%3&""5 (/%+&);1%3&""5'()1%'!"$%&'($)-+ P+GG."83(+"-[11'!"$%&'($).+E3'8 (.(+&"55.2%1"%'; 4.(+&"52+_'62+"_('!"$%&'($)/+4%8/"^.%',+&'.88%'',.11) Y%5"""53"2%"2"53 (.(+&'%''+"!"$%&'($)0+B8($% 1'(%""56 93&39/&3'"5!"$%&'($)+-(.2) -[11'!"$%&'($)/+ P+G913"8%<(/(/% %(/8'3"29/1+'+9/)+, (/%(.(+&9&+5&3G; '%`.31/3&3''G%"(; 91353&'G When Covered Amount of time Methods Materials Used/ Documentation -%''+"D F/& P13''&++G2'8.''+" N%,"(+"+,4.(+&"53"24.(+&]%'9+"'Y1(%' -%''+"D -%''+"DD -%''+"DDD?/&'?/&' F/& 7PD-.&$%)C2'8.''+"C 9&%'%"(3(+" 7PD-.&$%)C7PDL&%'%"(3(+"Cd%((]5/(iC7PDd&+.9 L+'(%&'CE&3";7%3&""5L&+8%''L+'(%&'C7PD D"(%&$%<c+G%<+&[CN%%9Y.("+(L&+,+."2 -%''+"DD F/& B8($() 4%3GP/3&(%&;E&25%E.12"5 ]%32"5C2'8.''+" ]%32"5C2'8.''+" -%''+"DDD F/& B8($() -%''+"Dj F=K/&' L&%'%"(3(+"C2'8.''+"C '.&$%) -%''+"Dj F=K/&' ]%32"5C38($() 4/%4.(+&"5L&+8%''SL35%'FFJFW"4&3""5 M3".31U c+<(+e%5"3"2a"23-%''+"sl35%'f?jfh" 4&3""5M3".31U 4%38/"54.(+&'X&53GC 4%38/"54.(+&'X&53GL&%'%"(3(+" dbma-m+2%1cdbma--.&$%) O/3(O &3(%'-3)(+!"2%&5&32.3(%4.(+&' ""$%! &'!()+! Page 6 1 st Stage: New/Rejoin ITPC Program Certification Application Packet Rev. 3/6/2010

7 8. DOCUMENT BIBLIOGRAPHY FOR THE LEVELS REQUESTED ON THIS APPLICATION,-$.&! F=!"$%&'()+,-+.(/01+&234.(+&4&3""5:P]7BB99183(+"O%Y'(%?= N%,"(+"+,4.(+&"53"24.(+&]%'9+"'Y1(%' H= 7PD-.&$%) >= 7PDL&%'%"(3(+" K= d%((]5/(i I= 7PDd&+.9L+'(%&' W= E&3";7%3&""5L&+8%''L+'(%&' T= 7PDD"(%&$%<c+G%<+&[ V= N%%9Y.("+(L&+,+."2 4%3GP/3&(%&;E&25%E.12"5 FF= 4/%4.(+&"5L&+8%''SL35%'FFJFW"4&3""5M3".31U F?= c+<(+e%5"3"2a"23-%''+"sl35%'f?jfh"4&3""5m3".311 FH= 4%38/"54.(+&'X&53G F>= 4%38/"54.(+&'X&53GL&%'%"(3(+" FK= dbma-m+2%1 FI= dbma--.&$%) FW= FT= FV= f%<-(.2%"(b5&%%g%"(?f= 4.(+&4G%-/%%('??= 4.(+&4&3""5-%''+"DB''%''G%"(?H= 4.(+&4&3""5-%''+"DDB''%''G%"(?>= 4.(+&4&3""5-%''+"DDDB''%''G%"(?K= 4.(+&4&3""50"31B''%''G%"(3"20%%2Y38[?I= -(.2%"(J4.(+&B''%''G%"(?W= f%<4.(+&b99183(+"?t= 4.(+&k.31,83(+"'c3"2+.(?V= 4.(+&P+",2%"(31()B5&%%G%"( -(.2%"(J4.(+&B''%''G%"( HF= 4.(+&-%1,JB''%''G%"( H?= 4.(+&c&"53"24&3""5L&+8%'' Page 7 1 st Stage: New/Rejoin ITPC Program Certification Application Packet Rev. 3/6/2010

8 9. (Parts A-F) Questions on Certification Requirements for Each Level Within parts A-F that follow, please provide complete answers for each of the questions listed, and be sure to list the documentation to confirm your compliance with the requirements that level, and to attach those files: 9-A.1: Level 1 (L1) 1. Number of hours for Level 1: 12 [Minimum required: 10 hrs total.] (a minimum of 10 cumulative hours of tutor training). 2. The requirements of Level 1 are: Met or X Exceeded 3. The 1 st set of Tutor Training Sessions is done in: Quarters X Semesters Other (specify): 4. The method(s) we use to track/document our training sessions is: 4.(+&4&3""5-5"J"-/%%(CB88.2%G3C4.(+&4G%-/%%(' 5. Our tutor training is done as a: Course X Non-Course Other (specify): 6. Documentation: these clearly titled documents/files (with page numbers specified) will verify: a. how our program has Met at least the minimum requirements, (suggested examples can include: sample tracking reports, tutoring-logs, etc.), and, 9-B.1: Level 1 (L1): Pre-requisite: No prior CRLA tutor training or certification is required to begin L1 Tutor Training. 1. Describe the training modes used for training Level 1 tutors. L1 Requirements: a min. of 6 hours of training, and MUST use all 3 of these training components: a) Tutor-trainer supervised, b) Interactive, and c) Live / Real-time training. X.&(&3""5'%''+"'3&%311(.(+&J(&3"%&'.9%&$'%2C"(%&38($%3"21$%;&%31J(G%= 2. Describe the training forms used for training Level 1 tutors. (Varied formats are recommended.) X.&(&3""5'%''+"'3&%2%'5"%2(+,%3(.&%3/5/1%$%1+,"(%&38(+"<(/(/%(.(+&J(&3"%&C3'<%113'%38/ +(/%&=4/%'%''+"+.(1"%'3"238($(%'<%.(1Z%83"Y%,+."2+"(/%7%$%1D-.GG3&)P/3&(+"L35%I+, (/'399183(+"= 3. Describe the main delivery medium(s) used for any remaining training time for Level 1 tutor training. -3G%3'3Y+$%= 4. The requirements of Level 1 are: Met or X Exceeded 5. Documentation: these clearly titled documents/files (with page numbers specified) will verify: a. how this minimum is at least Met (including samples of training materials, logs, etc.), and, 4+%"'.&%+.&(.(+&(&3""5'%''+"'3&%2%1$%&"5(/%+Y\%8($%'C<%%$31.3(%%38/'%''+"<(/3" 3''%''G%"(C</8/83"Y%,+."2"(/%N+8.G%"(EY1+5&39/)+"935%W+,(/'399183(+"= 9-C.1: Level 1 (L1): a min. of eight (8) of the following 15 listed topics must be covered in Level 1 training. 1. Mark an X by the eight (8), or more, topics you cover in your Level 1 Tutor Training, and X Definition of Tutoring and Tutor Responsibilities X Basic Tutoring Guidelines, and/or, Tutoring Do's, and/or, Tutoring Don'ts X Techniques for Successfully Beginning and Ending a Tutor Session X Adult Learners, and/or, Learning Theory, and/or, Learning Styles _ Assertiveness, and/or, Handling Difficult Students _ Role Modeling _ Setting Goals, and/or, Planning X Communication Skills X Active Listening and Paraphrasing _ Referral Skills X Study Skills Page 8 1 st Stage: New/Rejoin ITPC Program Certification Application Packet Rev. 3/6/2010

9 _ Critical Thinking Skills X Compliance with the Ethics and Philosophy of the Tutor Program, and/or, Sexual Harassment, and/or, Plagiarism _ Modeling Problem Solving _ Other (please specify): 2. Indicate if you have met or exceeded the minimum of 8 of these specific topics listed above. The Level 1 requirements are: X Met or Exceeded 3. Documentation: these clearly titled documents/files (with page numbers specified) will verify: a. how this minimum is at least Met (including samples), and, [Example: Active Listening and Paraphrasing: see the Tutor Training Syllabus, pp. 4-5 ] 9-D.1: Level 1 (L1): Required: a minimum of 25 initial hours of actual tutoring experience for Level The tracking method(s) we use to track our tutors actual tutoring experience include the following: -(.2%"(',11+.(3f%<-(.2%"(B5&%%G%"(Y%,+&%&%8%$"5(.(+&"5=B,(%&8+G91%("5(/%35&%%G%"(C+.& +,,8%'(3,,"9.('(/%'(.2%"(_'",+&G3(+"3"2&%^.%'("(+4.(+&4&38C</8/'(/%'+,(<3&%(/3(G3"35%' 3"2(&38['+.&(.(+&'C'8/%2.1%'3"2'(.2%"(23(3=4/%+,,8%'(3,,G%GY%&&%8+&2'(/%399+"(G%"((G%" 4.(+&4&383'<%113'(/%f%<-(.2%"(B5&%%G%"(=4G%'/%%('3&%31'++",1%(+$%&,)/+.&'=-"8%+.& (.(+&'<+&[+"3$%&35%CF@/+.&'9%&<%%[C(/'&%^.&%G%"('()98311),.1,11%2<(/"(/&%%<%%['= 2. The requirement of 25 hours of actual tutoring experience for Level 1 is: X Met or Exceeded 3. These are examples of our tutor tracking documentation: 4/%f%<-(.2%"(B5&%%G%"(83"Y%,+."2"(/%N+8.G%"(EY1+5&39/)+"935%I+,(/'399183(+"=g+. G3)31'+$'(+.&B88.2%G37+5"935%(+'%%</%&%<%388%''+.&(.(+&(&38["59&+5&3G+"1"%= 4. Documentation: these clearly titled documents/files (with page numbers specified) will verify: a. how this minimum is at least Met (including samples), and, 9-E.1: Level 1 (L1): Describe below how your program completes the tutor selection criteria requirements: 1. The Step 1 interview option(s) we use for L1 tutor selection, and how we use them, are: 4/%B'''(3"(N&%8(+&"(%&$%<'"%<(.(+&399183"('3"2G3[%'32%8'+"(+/&%Y3'%2+"/'%$31.3(+" +,(/%&8/3&38(%&3"23Y1()(+,((/%"%%2'+,+.&2%93&(G%"(=X.&f%<4.(+&B99183(+"C4.(+& k.31,83(+"'c3"2+.(c3"24.(+&p+",2%"(31()b5&%%g%"(3&%1'(%2"(/%n+8.g%"(ey1+5&39/)+" 935%I+,(/'399183(+"=B,(%&(.(+&'3&%/&%2Y)(/%B'''(3"(N&%8(+&C(/%)3&%'8/%2.1%2(+3"/+.&+, a"(3[%b<(/(/%b832%g8-.99+&(p++&2"3(+&3"2(/%"3&%'8/%2.1%2,+&(/%"%`(3$313y1%'%''+"+, (.(+&(&3""5=4/%4.(+&c&"53"24&3""5L&+8%''%"'.&%'(/3((.(+&'G%%(+.&'(3,,3"23&%8+G,+&(3Y1% <(/+,,8%9&+8%2.&%'3"2/3$%3"3<3&%"%''+,+.&%`9%8(3(+"',+&"%<(.(+&'= 2. The Step 2 knowledge verification means we use for L1 tutor selection, and how we use them, are: X.&2%93&(G%"(&%^.&%'3(1%3'(3"BJ"(/%8+.&'%3"399183"(<11(.(+&<(/'+G%%`8%9(+"'S8+.&'%' (/3('(.2%"('&3&%1)%3&"B_'U=-(.2%"((&3"'8&9('3&%%`3G"%2,+&8+"5&.%"8%= 3. The requirements of Level 1 tutor selection are: X Met or Exceeded 4. Here are clearly titled document samples (with page numbers specified) to confirm compliance. 5. Documentation: these clearly titled documents/files (with page numbers specified) will verify: a. how this minimum is at least Met (including samples), and, 9-F.1: Level 1 (L1): 1. Mark an X for all options that you use to evaluate your tutors for this level: X a formal, &/or, an informal evaluation procedure is in place X a formal, &/or, an informal evaluation occurs on a regular basis X results of their evaluation process are made known to tutors other (please specify): Page 9 1 st Stage: New/Rejoin ITPC Program Certification Application Packet Rev. 3/6/2010

10 2. The evaluation requirements for Level 1 tutors are: X Met or Exceeded 3. Here are clearly identified samples, with page numbers specified, of these tutor evaluations: A38/'%G%'(%&C<%"(3(%%$31.3(+"+,+.&(.(+&'<(/3-(.2%"(J4.(+&B''%''G%"(=B,(%&+"%<%%[C<% '%"2(/%3''%''G%"('(++.&83G9.'(%'("58%"(%&,+&9&+8%''"5=O/%"<%5%((/%&%'.1('Y38[C(.(+&',11 +.((/%4.(+&-%1,JB''%''G%"(=X"8%(/''8+G91%(%C(/%(.(+&'('2+<"<(/(/%B'''(3"(N&%8(+&+&(/% B832%G8-%&$8%'P++&2"3(+&(+5++$%&(/%'(.2%"(3''%''G%"('3"2(/%'%1,J3''%''G%"(=B&%3'+, 8+"8%&"3"28+"'2%&3(+",+&,.(.&%(&3""5'%''+"'3&%8+"'2%&%23'3&%'.1(+,(/%%$31.3(+"9&+8%''= 4. Documentation: your clearly titled documents/files (with page numbers specified) should verify: a. how this minimum is at least Met (including samples), and, THE END! Thank you for applying. Rick Sheets, ITPC Coordinator Page 10 1 st Stage: New/Rejoin ITPC Program Certification Application Packet Rev. 3/6/2010