Slingerland Teacher Training: July 1 + July 5-29, 2022

All courses are approved for 133 Washington State clock hours or 6 continuing education units are available through the University of San Diego. Additional fee applies.

Namerequired

First Name

Last Name

Addressrequired

City, State, Ziprequired

Email Addressrequired

Phone Numberrequired

Schoolrequired

Role/Position for 2022-2023 School Yearrequired

Please select course (tuition: $3,075 – a payment link will be forwarded to you)required

Level 1: Introductory Comprehensive Class

Level 2: Continuum Comprehensive Class (Prerequisite: Level 1)

Level 3: Third Level Continuum/Intern Class (Prerequisite: Levels 1 and 2, teacher approval)

Level 4: Fourth Level Continuum/Intern 2 Class (Prerequisite: Levels 1, 2, 3, teacher approval)

Highest Level of Educationrequired

Credential(s) Heldrequired

Years Teaching Experiencerequired

Have you had prior Slingerland training or other multisensory structured language courses?

Hamlin Robinson School does not discriminate on the basis of race, color, religion, disability, gender, gender identity, sexual orientation, national or ethnic origin, or other legally protected status in admission of otherwise qualified students or in providing access to the rights, privileges, programs, or activities generally available to all students and their families. Similarly, the school does not discriminate in hiring or employment practices on the basis of these characteristics. Hamlin Robinson School implements policies related to learning differences as appropriate to support the school's mission statement.

Criminal History and Washington State Patrol Check

Applicant Disclosure (pursuant to RCW 43.43.845)

I understand I must answer this application truthfully and completely. Any falsifications or deliberate misrepresentation, including omission of material fact, and/or failure to notify Hamlin Robinson School if disclosure information provided changes, can be grounds for denial of employment or continued employment. I also understand that, upon my request to Hamlin Robinson School, a copy of the results report from WSP will be furnished to me.

By completing this form, I certify under penalty of perjury according to the laws of Washington that the following information is true and correct.

Namerequired

First Name

Middle

Last Name

Gender

Male

Female

Previous Names Used (e.g. maiden/birth name):

Date of Birthrequired

Have you ever been convicted of ANY crime (convicted includes ALL instances in which a finding of guilty or nolo contendere is the bases of conviction and/or all proceedings in which a sentence has been suspended or deferred.)

Yes

No

Have you ever been convicted of a crime relating to sexual abuse, exploitation, or physical abuse?

Yes

No

Have you ever been convicted of any crimes relating to drugs?

Yes

No

Have you ever been convicted of any crimes relating to financial exploitation, including extortion, theft, robbery or forgery?

Yes

No

Do you currently have any outstanding criminal charges or warrants against you in Washington or in any other state or country?

Yes

No

Have you ever been convicted of domestic violence or assault?

Yes

No

If you answered YES to any of the questions above, please attach a supplemental sheet with a brief explanation of the convictions.

Attach up to 1 file with a maximum size of 10MB

No file chosen

Following receipt of this notice and fingerprint record, HRS shall use these forms as a request and may contact the Fingerprint Records Office of the Superintendent of Public Instruction, and/or Washington State Patrol by mail, fax, or HRS electronic access to records at OSPI or WA State Patrol. The request shall include the above information.