Application for Admission into Early Grade Reading Certificate Course

Supported by the Northern Education Initiative Plus

Name Male/Female Date

Institution .

  1. Professional Experience

List your last 5 years of professional work experience.

Institution
(provide name and address) / Start date / Starting Position / End date / Ending Position / Supervisor Contact Information
  1. Professional Preparation

List all education you have received, starting with the most recent (attach proof of all degrees and certificates).

Institution
(provide name and address) / Start date / End date / Program / Degree level
(BS/MA/PhD) or Certificate / Did you complete the program?
  1. Course Requirements

Participants are expected to cost-share the expenses associated with this certificate course. Each of the following criteria are requirements for course completion and, ultimately, certificate receipt. Inability to agree to any of the following will result in an application denial or revocation of certificate.

heck the box to the right indicating that you understand the course requirements / Yes
I understand and agree
(initial)
There is no fee associated with application, tuition or enrollment.
I have access to and will use email for communication.
Travel expenses and per diem will not be provided to me.*
I am responsible for my transportation to each week’s class location.
The locations for the class will be in Abuja, Sokoto, Bauchi, and Abuja.**
Class attendance is compulsory.
A ten-page independent research paper is required.
I am required to present at least Three PowerPoint presentations.
Out-of-class readings, assignments, writings, and journals are required, including independent work that will take place between class session weeks.
Some assignments will be turned in via email between class weeks.
Participation in class discussions/feedback is required.
I will provide a notebook, paper, writing implements, and will print articles, handouts, and other class materials as necessary.

** Accommodation will be provided by NEI Plus for participants who are out of town.

* Two Tea breaks and lunch will be provided by NEI Plus on the days of the face-to-face course instruction.

  1. Course Calendar of Events

Indicate your availability to attend the following events for the given dates and locations.

Activity / Dates / Location / Yes
I can attend
Opening Ceremonies
Week 1 of Instruction / 11-14 September 2017 / Abuja
Week 2 of Instruction / 12-14 October 2017 / Sokoto
Week 3 of Instruction / 9-11 November 2017 / Bauchi
Final Research Presentations Certificate Ceremony / 4-6 December 2017 / Abuja
  1. Provide a letter from your institution/organization providing permission for you to be away from work to participate in the course.
  2. Provide a letter indicating party to be responsible (personal responsibility) for all the shared cost component of the course to be covered by you.
  3. Personal Statement

Attach a 2-page typed essay summarizing why you would like to be enrolled in this course and the strengths you can bring. Describe how participation in this course will support your current career path and how you will use this knowledge in the future.

  1. Statement of Importance

Attach a 2-page typed essay describing the components of high-quality reading instruction and the importance of literacy for Nigeria and its children.

  1. Future Consideration

Yes / No

If you are not chosen for the first session of this course, would you like to be considered for the second session to be held in early 2018 (check ‘yes’ or ‘no’)?

  1. I ______certify that the information provided on this form is true, correct, complete to the best of my knowledge, and made in good faith.

Signature ______Date______

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