Micro Externship for Educators Application

MICRO-EXTERNSHIP FOR EDUCATORS APPLICATION

LOZIER MICRO-EXTERNSHIP FOR EDUCATORS APPLICATION

If you are interested in this paid externship, please submit the completed application by April 14, 2025. If selected, you will be notified by April 28, 2025.

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INFORMATION

First Name

M.I.

Last Name

Phone Number (Home)

Phone Number (Cell)

Phone Number (Work)

Address

City

State

Zip Code

School where you teach

Your Title

School Administrator

School Administrator E-mail

Are you a Career & Technical Educator?

Have you participated in the Micro-Externship for Educators programs before?

APPLICATION QUESTIONS

1. Please describe how your students will benefit from your participation in the educator externship program.

2. Please describe how you and your school/district will benefit from the educator externship experience.

3. Teachers, please list the classes you teach. Counselors or other staff, please list your areas of specialization or major responsibilities.

4. Have you participated in any other externship program? If yes, please describe.

5. List any work experience or volunteer activities post college other than teaching/counseling.

PLEASE READ BEFORE SUBMITTING APPLICATION

I hereby certify answers and statements on this application are true and may be relied upon when considering my application to the Lozier Educator Externship Program. I further understand any material omission, false answers, or false statements by me on this application may result in denial of my application, revocation of my eligibility to participate in the program, and/or my exclusion to participate. I further acknowledge and agree I will not accept any compensation, money or other renumeration whatsoever from any person, entity or employer for my services performed as a or may participation as an intern in the program, other than the intern stipend to be paid to me by, Lozier, and under the program. If I violate the preceding sentence, or if I am determined to have been ineligible to participate I the program, I agree to refund to Lozier, any stipend paid to me.

I have read and agree to the above statement

Select to Confirm

The Educator Externship and experience is an equal opportunity program available regardless of an individual’s ancestry, age, color, disability, genetic information, gender identity or expression, marital status, military or veteran status, national origin, pregnancy, race, religion, sex/gender, sexual orientation, or other status protected by federal, state or local laws.