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Instructions: Complete the questions below. An exclamation point (!) indicates a required question. When finished, click the "Submit your answers" button at the bottom of the screen.

This questionnaire asks about the following topics. Please have this information handy while you complete the form to prevent the form from timing out. 

• Current and past job responsibilities that identify your strengths as an examiner
• Education (i.e., areas of study and degrees/certifications earned)
• Experience with career and technical (vocational) education
• Previous experience with quality/continuous improvement, assessment, evaluation, and/or observation of organizations
• Dates that pose schedule conflicts for the fall of 2021

Please note: Approximately 10 to 35 examiners will be selected per technology center accreditation team each year. Selected examiners will be notified of acceptance on or before August 24.

Thank you for your interest!

Accreditation Division

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1. Contact Information

2. Background Information

3. Conflict of Interest

Read the following:

Definition of Conflict of Interest

Conflicts of interest disqualify a potential examiner from evaluating a particular school. In agreeing to serve as an Accreditation examiner team member, I certify that I understand what constitutes a conflict of interest.

• Being a recent appointee or employee of the Technology Center District, or having close relatives who are appointees or employees of the educational institution (not applicable to state staff).
• Having formed or expressed an opinion bearing on the accreditability of the Technology Center District.
• Being employed by an institution or entity that is a direct competitor of the Technology Center District.
• Being a graduate of the Technology Center District (not applicable to state staff).
• Having vested interest or conflict of interest, either current or planned, in any component of the Technology Center District.

A schedule conflict is not conflict of interest. If you have a schedule conflict you can identify the conflicting dates later in this application.

Do you understand the above situations that constitute a conflict of interest for accreditation examiners?

Please check the box next to each school at which you may have a conflict of interest. Check "No conflict of interest" if you do not have a conflict of interest.

Describe the potential conflict of interest for each institution you indicated in the previous question. Write "None" or "N/A" if you do not have a conflict of interest related to any of the schools listed.

4. Schedule Conflict
(Dates and meeting formats subject to change, if necessary)

Site 1:

• Sept. 1 Virtual New Examiner Training
• Sept. 7 Virtual Examiner Prep Day
• Sept. 8-9 Hybrid Visit. (Sept. 8 Virtual Interviews. Sept. 9 Onsite)

Site 2:

• Sept. 15 Virtual New Examiner Training
• Sept. 20 Virtual Examiner Prep Day
• Sept. 21-23 Hybrid Visit. (Sept. 21 Virtual Interviews. Sept. 22-23 Onsite)

Site 3:

• Sept. 28 Virtual New Examiner Training
• Oct. 4 Virtual Examiner Prep Day
• Oct. 5-7 and Oct. 12-14 Hybrid Visit. (Oct. 5-7 Virtual Interviews. Oct. 12-14 Onsite) 

Site 4:

• Oct. 27 Virtual New Examiner Training
• Nov. 1 Virtual Prep Day
• Nov. 2-5 Hybrid Visit. (Nov. 2-3 Virtual Interviews. Nov. 4-5 Onsite)

Please check the appropriate box next to each date for which you have a schedule conflict (refer to the list above). If no schedule conflict, check "No schedule conflict."

5. Confidentiality Agreement

By agreeing to serve as an Accreditation examiner team member, I understand the following:

• I may be reviewing confidential and privileged information intended for the sole purpose of accreditation.
• Any unauthorized review, use, disclosure, or distribution is prohibited.

Do you understand that information in the Technology Center applications, discussions at Examiner Boot Camp, and data gathered and shared at the site visits must be kept confidential?