State Advisry Panel Fr Special Educatin Twin Twers East Suite 1870 Atlanta, Gergia 30334-5040 Kimberleigh Beard, Chair bkimberleigh@gmail.cm Paul West, C-chair pawest@frsyth.k12.ga.us Thank yu fr yur interest in applying fr a psitin n Gergia s State Advisry Panel fr Special Educatin. The Individuals with Disabilities Educatin Act (IDEA) mandates that all states have special educatin advisry panels t include representatin frm stakehlders wh are cncerned abut prviding imprved educatinal pprtunities t children with disabilities. The gal in Gergia is t have an active State Advisry Panel with brad representatin frm acrss the state t advise the Gergia Department f Educatin (GaDOE) regarding the State Perfrmance Plan, State Systemic Imprvement Plan, State Persnnel Develpment Grant, Gergia Cntinuus Imprvement Mnitring Prcess, IDEA Regulatins and ther initiatives designed t imprve utcmes fr all children with disabilities in Gergia s schls. Please read the fllwing qualificatins fr membership n the Panel. If yu are interested in seeking membership n the State Advisry Panel, please cmplete the applicatin, with references, and submit n later than March 19, 2018 in rder t be cnsidered fr membership in 2018-2019. The membership cmmittee will review applicatins and present recmmendatins t the State Bard f Educatin fr final apprval at the May 2018 bard meeting. QUALIFICATIONS/REQUIREMENTS 1. Applicants must be a resident f Gergia, at least 18 years f age, a high schl graduate and meet criteria in at least ne f the fllwing categries: Individuals with disabilities Parents/Guardians f a child with a disability age birth t 26. Teachers f students with disabilities (regular educatin and special educatin) Educatinal administratrs Representatives f institutins f higher educatin that prepare special educatin and related services persnnel Administratrs f prgrams fr children with disabilities Representatives f private schls and public charter schls Representatives f a vcatinal, cmmunity, r business rganizatin cncerned with the prvisin f transitin services t children with disabilities 2. Individuals with disabilities and parents must make up 51% f panel membership. 3. Applicants agree t serve a three-year term. 4. If the applicant is a member f a lcal advcacy rganizatin, a lcal special educatin advisry cmmittee, r a lcal interagency cmmittee, this infrmatin shuld be indicated n the applicatin. APPOINTMENT Panel members are apprved by the State Bard f Educatin t serve a three-year term. Applicants emplyed by a lcal schl system r cllege/university shuld ntify their lcal superintendent r department chairpersn f their intent t apply fr Panel membership. Nminees will be presented t the State Bard f Educatin fr apprval and will then be ntified f their apprval fr Panel membership.
TRAVEL REQUIREMENTS The Panel meets fur times each year. The applicant shuld plan fr release time frm jb respnsibilities fr tw days fr each meeting. Travel and subsistence expenses are reimbursed at state rates. In mst instances, ldging is paid by the GaDOE, and members are reimbursed fr meals and mileage at apprved state rates. Respite care may be reimbursed at designated rates. MEMBERSHIP RESPONSIBILITIES Each Panel member will be expected t attend all fur meetings per year. Special Educatin State Advisry Panel Webpage: http://www.gade.rg/curriculum-instructin-and- Assessment/Special-Educatin-Services/Pages/State-Advisry-Panel-%28SAP%29.aspx 2
STATE ADVISORY PANEL FOR SPECIAL EDUCATION APPLICATION FOR MEMBERSHIP New Applicant Current Member Hme Address Date City Cunty 9 digit zip cde Wrk Address City Cunty 9 digit zip cde Hme Phne Wrk Phne Ext FAX Hme Cngressinal District Number (see cngressinal map n SAP webpage) Please check all that apply Individual with disability (Area f disability) Accmmdatins needed (Please be specific) Parent/Guardian f a child with a disability age birth t 26 Child s date f birth Child s area f disability Teacher f students with disabilities (Special r Regular Educatin). Indicate area(s) & level(s) taught Representative f institutin f higher educatin that prepares special educatin and related services persnnel. f institutin State r lcal educatin fficial Administratr f prgrams fr children with disabilities I have served n the State Advisry Panel previusly. If checked, please indicate years f service I will cmmit t attend fur, tw-day meetings each year and I have my emplyer s apprval. I am a member f a lcal advcacy grup, lcal special educatin stakehlder grup, r lcal interagency cuncil. If checked, please list panel(s) and/r cuncil 3
Have yu ever r d yu currently serve n an advisry bard? Yes N If yes, please explain/describe: Educatinal backgrund: Other areas f specialty training: Current emplyer, jb title, and basic respnsibilities: Prfessinal/advcacy affiliatins: Hw did yu find ut abut the State Advisry Panel? Website Current/previus panel member Lcal schl district Other If ther, please explain: If yu need mre space, please answer the fllwing n a separate sheet: Why d yu want t be a member f the State Advisry Panel? What is yur visin fr students with disabilities in Gergia? 4
Please prvide tw references: (If an emplyee f a schl system, state agency, r prfessinal rganizatin, we ask that at least ne reference is prfessinal.) Reference # 1 Title Address City State Zip cde Phne Reference # 2 Title Address City State Zip cde Phne Applicant Signature Date By submitting this applicatin t becme a member f the State Advisry Panel t the Gergia Department f Educatin, the applicant acknwledges that this applicatin is subject t the Gergia Open Recrds Act, 50-18- 70 et seq. Please submit cmpleted applicatins including narrative respnses t questins by March 19, 2018 via mail, email r fax t: Dr. Zelphine Smith-Dixn Gergia Department f Educatin Divisin fr Special Educatin Services & Supprts 1870 Twin Twers East 205 Jesse Hill Jr., Drive SE Atlanta, GA 30334 Fax: 770-344-4482 E-mail: spedsap@de.k12.ga.us 5