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DIRECTed

DirectED Training Application Form
DIRECTed Training Application Form

Please fill out the following application form and when finished click the "Continue" button.

Your Contact Information:
( * = Required Information NOTE: Enter "none" if not applicable)
*Title: 
*First Name:    *Last Name: 
*Address: 
Addl. Address: 
*City:    *State: 
*Zip:    Country:(if other than United States) 
*Office Phone:     Home Phone: 
*E-mail Address:   
Early Childhood Center Information:
*Name of Early Childhood Center: 
*Name of LCMS church affiliated with the Early Childhood Center:
*Address:     Addl. Address: 
*City:    *State: 
*Zip:    Country:(if other than United States) 
*FAX:     *LCMS District: 

Current Position and Status:
*Your Current Position:   If "Other" selected, please
specify your "Other Position" here: 
*Total years at present LCMS Early Childhood Center: 
*Total years at Early Childhood Centers: 
*Total years in Early Childhood work: 
*Total years of Early Childhood administration experience: 
*Total years of administration experience at present LCMS Early Childhood Center: 
*Are you currently on the LCMS Roster of Commissioned Ministers?:
If Yes, please enter your Classification:  If "Other" selected,
please enter your Classification here: 

Your Education: (Please enter your major & name of Institution NOTE: Enter "none" if not applicable)
*Associate Degree in/from: 
*Bachelor's Degree in/from: 
Bachelor's Degree#2 in/from: 
*Master's Degree in/from: 
*Other Education: 
*Lutheran Teacher Diploma Certification:   
Note: If Yes, Please select the city of the institution granting the LTD: 

Your Professional Aspirations:

In the space below write a brief personal statement that describes why you are interested in participating in the training workshops and how you think the training will benefit you.

Note: In order that you might access your information and update it from time to time, please enter a "Username" and "Password" in the spaces below. Write them down and when returning you can use them to access your personal information as well as sign up for additional classes.
The length of your username and password must be between five and ten alphanumeric characters. No symbols or spaces please!
*Username:    *Password: 
Select Workshops (Place a check mark in all you are interested in taking.)
(Click Here to see detailed descriptions of classes.)
Leadership/Stragic Planning Staff Development
Child Development Family Systems
Lutheran Teachings Business Management/Development

NOTE: Please click the "Continue" button ONCE to proceed.
Depending on your connection to the Internet, it may take from a few seconds to several minutes for your information to be stored in the database on the server.
When that process is completed, you will be taken to another page which you can print out and forward to your district office.
Thank you for your patience.
 
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