CREATE Equity-Centered Critical Friendship Registration Form

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Equity Centered Critical Friendship Institute (ECCF) is offered as a 16-hour institute during which participants encounter what it looks, sounds, and feels like to be a part of a community of practitioners fiercely committed to educational equity and excellence.

Participants will engage:
- New understandings of individual and collective identity; concepts pertaining to racial equity; reflection on equity in education and broad systemic inequities
- Strategies for community-building and reflection through facilitated protocols and open discussions
- Intentional community building through established agreements and reflection
- Practice of skills needed for participation in and facilitation of equity-centered, collaborative practices

To learn more, visit the Professional Learning page of CREATE's website (https://createteacherresidency.org/equity-centered-professional-learning/)

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CREATE INSTITUTES ARE OFFERED IN VARIOUS FORMATS IN 2021-22 school year
(Please note: wherever we indicate an institute will take place in person, it is our plan to consider rescheduling it as virtual if COVID conditions dictate this level of safety.)

OPTION 1: 4 weekdays; in person (9am-4:00pm; June 13-16, 2022)
OPTION 2: 4 weekdays; in person (9am-4:00pm; July 18-21, 2022 )
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COST:

-General Public: $500
-CREATE School Employees: complimentary seats available with building leader approval (details in Section 2) and see list of CREATE schools below
-CREATE partner organizations: complimentary seats available; 2 per partner organization
-Half-price seats offered to those engaging a second full, 4-day institute with CREATE within a year

Questions? Contact Rosalynne Duff (rduff@atlncs.org)

www.createteacherresidency.org

For which institute are you registering? *

OPTION 1 (June, 2022; see details above)

OPTION 2 (July, 2022; see details above)

First and Last Name *

Which statement(s) best describes your school or organization for 2021-22 school year *

I work for a CREATE partner organization (School Reform Initiative, National Center for Teacher Residencies, Atlanta Public Schools central office) and not a specific school

I work on the CREATE Teacher Residency team (as a USC or other staff)

I work for a school within APS, but am not a CREATE school employee (see list of schools just below)

I work for a school outside of the metroAtlanta region and outside of APS

CREATE SCHOOL: Atlanta Neighborhood Charter Elementary

CREATE SCHOOL: Atlanta Neighborhood Charter Middle

CREATE SCHOOL: Benteen Elementary

CREATE SCHOOL: Bolton Academy

CREATE SCHOOL: Burgess-Peterson Academy

CREATE SCHOOL: Centennial Academy Charter

CREATE SCHOOL: Drew Charter Elementary

CREATE SCHOOL: Drew Charter Junior

CREATE SCHOOL: Garden Hills Elementary

CREATE SCHOOL: Hollis Innovation Academy

CREATE SCHOOL: Howard Middle

CREATE SCHOOL: Kindezi Old Fourth Ward

CREATE SCHOOL: Price Middle

CREATE SCHOOL: King Middle

CREATE SCHOOL: Parkside Elementary

CREATE SCHOOL: Sutton Middle

CREATE SCHOOL: Thomasville Heights Elementary

CREATE SCHOOL: Toomer Elementary

CREATE SCHOOL: Wesley International Academy

CREATE SCHOOL: Westside Atlanta Charter

Other:

Required

If you indicated above that you work for a "partner organization" or "a school within the Atlanta region that is not in CREATE", please specify the school/organization

For CREATE school employees utilizing a school scholarship only: Completion of this form requires your building leader's approval. What is the name, job title, and email address of the building leader who has granted their approval for your registration? *

I serve as a CREATE SBM or CT (or fully participate in the SBM/CT professional learning training program) during 2021-22 school year *

2021-2022 matched CREATE School-Based Mentor

2021-2022 matched CREATE Cooperating Teacher

2021-2022 participant in school-year CREATE SBM/CT PL, but am not matched

None of the above

Are you an educator who attended another CREATE PL session since summer 2021? If so, which? *

I have not attended another CREATE PL since summer 2021

I participated in CREATE's Black Men in Education collaborative in summer 2021 [Will be invoiced at half-price]

I have participated in ECCF (equity-centered critical friendship) since summer 2021 [Will be invoiced at half-price]

I have participated in PPI (compassion training) since summer 2021 [Will be invoiced at half-price]

I participated in Equity Educators in Action or Cultivating Equity Leaders during an APS PL day (during 2021-22 SY)

Required

Current position/Job title *

Mailing Address *

Email Address *

Mobile phone number *

Self identify your gender *

Self identify your race/ethnicity *

Do you have experience with Critical Friendship (CF) protocols through former work in a CF group, ECCF institute, or School Reform Initiative meeting? *

Yes

If you answered YES to the above, please provide a brief description, including approximate date(s).

Please share 1-3 sentences about why you would like to participate in this institute at this time. What do you hope to get out of it?

Is there anything you'd like the course facilitators to know?

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