Dual Enrollment Instructor Application

Dual Enrollment Instructor Application

For Credit Courses
Credentialing Requirements for teaching:

Transferable courses: Master’s degree in the teaching discipline OR Master’s degree and 18 graduate level credits in teaching discipline.

Non-transferable courses: Master’s degree in the teaching discipline OR Master’s degree and 18 graduate level credits in teaching discipline OR Bachelor’s degree in teaching discipline OR Associates degree in teaching discipline OR Demonstrated competencies in the teaching discipline.
Date*

MonthDayYear
Date
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Social Security Number*
Preferred Email*
example@example.com
What school district do you teach for?*
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Courses/Area interested in Teaching*
Education
High School
High School Address
Graduation date
Diploma Type
Example: Standard High School Diploma
College/University Name
College/University Location

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Certificate/Diploma/Degree Attained
Dates Attended
College/University Name
College/University Location

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Certificate/Diploma/Degree Attained
Dates Attended
College/University Name
College/University Location

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Certificate/Diploma/Degree Attained
Dates Attended
Related Certification
Certificate
Issuer of Certificate
Date Certificate Attained
Expiration Date (if applicable)
Certificate
Issuer of Certificate
Date Certificate Attained
Expiration Date (if applicable)
Certificate
Issuer of Certificate
Date Certificate Attained
Expiration Date (if applicable)
Teaching, Instruction or Training-Related Work Experience
Employer Name
Supervisor
Position
Job Field Or Teaching Discipline
Start Date
End Date
Employer Name
Supervisor
Position
Job Field Or Teaching Discipline
Start Date
End Date
Employer Name
Supervisor
Position
Job Field Or Teaching Discipline
Start Date
End Date
Employer Name
Supervisor
Position
Job Field Or Teaching Discipline
Start Date
End Date
Attachments

Applicants are required to submit their resume using the file upload box below. Applicants can also upload their unofficial transcripts.
File Upload*

Cancelof
Upon approval to teach as a dual enrollment instructor, Official Transcripts must be submitted to RPCC. Electronic transcripts can be sent directly from the college or university to ssealey@rpcc.edu.
Signature

Clear
Should be Empty:

Dual Enrollment Instructor Application

Credentialing Requirements for teaching:

Education

Related Certification

Teaching, Instruction or Training-Related Work Experience

Attachments