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Practice Application2017-2018 Illinois NB Renewal Candidate Fee Subsidy ApplicationWelcome to the application for the Illinois NB Renewal Candidate Fee Subsidy.The National Board Resource Center (NBRC) at Illinois State University Is excited to announce that the application for the Illinois NB Renewal Candidate Fee Subsidy is open from October 27, 2017 at 10 am to April 30, 2018 at midnight.Timeline:? Application opens October 27, 2017 at 10am.? You must make payment to NBPTS by January 31, 2018.? You must complete the Illinois NB renewal application later than April 30, 2018 at midnight.? Names of applicants will be posted to the NBRC website every Monday, Tuesday and Wednesday from November 13, 2017 10am through May 3, 2018.? You must submit your PPG to NBPTS by May, 2018 (actual date determined by NBPTS).? Payments of $1,250 will be made to NBPTS in July-August 2018.STOP! Do not proceed until you: 1) complete this practice application and 2) read the details about the Illinois NB Renewal Fee Subsidy Application.Section IFirst Name:2. Last Name:3. Middle Name: 4. Maiden Name:Use N/A if this question does not apply.5. Birthday:mm/dd/yyyy6. Social Security Number:Last 4 digits only! XXX·XX·----7. Home Phone:Include area code - no spaces or dashes- 30943616358. Work Phone:Include area code- no spaces or dashes- 30943816359. Home Address - Street:10. Home Address- City:11. Home Address- State:12. Home Address - Zip:13. Home Address- County:14. Email:Email address where you can be reached at all times including summer. School emails tend to be blocked.Please be sure this is typed accurately15. Confirm Email:16. Current Teaching Position· Select all that apply.High School Middle School Elementary School Pre-SchoolCurrently not teachingOther,please specify17. Current position in the public school system:Select all that applyTeacher Counselor Administrator Instructional Coach RetiredCurriculum DirectorOther, please specify18. Name of school where you are currently employed:19. School Address- Street:20. School Address- City:21. School Address - State:22. School Address - Zip:23. School Address - County (not country):24. Region, County, District, Type (RCDT) Code:Example City of Chicago- 150162990·25·0000 - click on RCDTS Code Lookup RCDTS Lookup Page Search by District.25. NBPTS Teaching Certificate - Include the Discipline and Developmental Level - Example - Art/Early and Middle Childhood: Use this link to understand and decided which NB certificate you will chose to complete . The certificate should complement your Illinois license.26. What is your Renewal Candidate Identification Number?Your Renewal Candidate ID starts with C011 and is followed by five additional numbers27. You must be in your 8th or 9th year of NB certification to begin the renewal process.What is the year of your last NB certification?Section II Is your school on the Academic Early Warning List? () Is your school on the Academic Watch List? Does your school have 50% or more students on free or reduced price lunch status?To be eligible for the Illinois NB Renewal Candidate Fee Subsidy, all candidates must hold a valid Illinois Educator Identification License (IEIN). This applies even if your current position does not require one. This information can be found in the Illinois Educator Licensure Information System (ELIS) ( ): Primary Information – Full Name:Jane DoeIEIN:123456DOB:mm/dd/yyyyGender:femaleFormer Name:DeerTo be eligible for the Illinois NB Renewal Candidate Fee Subsidy, all candidates must hold a valid Professional Educator License (PEL). This applies even if your current position does not require one. This information can be found in the Illinois Educator Licensure Information System (ELIS) under “MY CREDENTIALS” (): SelectLicense IDLicenseStatus CodeSelect1234567Professional Educator LicenseTo be eligible for the Illinois NB Renewal Candidate Fee Subsidy, applicants must agree to the questions below and authorize their signature to confirm agreementDo you agree that your Illinois license is current and valid and unencumbered?Do you agree that you that you applied to NBPTS and paid the $1,250 assessment fee for the 2017-2018 renewal registration cycle?Do you agree that your NB certificate is current and not expired?Do you agree that you are in your eighth or ninth year of your NB certification?Do you agree to submit the completed NB Profile of Professional Growth (PPG) to NB between April 1, 2018 and May, 2018?The Illinois NB Renewal Candidate Fee Subsidy will be paid directly to NBPTS for those candidates who are approved for the Illinois NB Renewal Candidate Fee Subsidy, paid the $1,250 assessment fee for the 2017-2018 cycle and submit a completed PPG to NB by May, 2018. NBPTS will post this payment to the NB account of the Renewal Candidate applicant in July-August 2018. The applicants’ personal credit card will be reimbursed for the total $1,250 paid to NB by the applicant. Do you agree that you understand that the Illinois NB Renewal Candidate Fee Subsidy will be paid directly to NBPTS for those applicants who are approved to receive the Subsidy, who paid the $1,250 assessment fee for the 2017-2018 cycle, and who agree to submit the completed NB Profile of Professional Growth (PPG) to NB between April 1, 2018 and May, 2018?Do you agree that you submitted complete and correct information in the Illinois NB Renewal Candidate Fee Subsidy Application?Check agree to authorize your signature to confirm agreement to your responses in Section II.SECTION III – District Administrator Information Official school district name:Address of District (Street):Address of District (City):Address of District (State):Address of District (Zip Code):Title of District Administrator:SuperintendentAssistant SuperintendentPrincipalHuman Resources DirectorOtherName of District Administrator:Telephone number of District Administrator (no spaces or dashes): Email of District Administrator: ................
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