NYSCAA Resources

Name*

First Last

Community Action Agency*

Work Address*

Street Address Address Line 2 City State ZIP Code

Phone Number*

Email*

Attendance:Please affirm that you are able to attend the full two-day training and other applicable activities/meetings/events below:

Training Session*

YES, I can attend the entire training (in a central location in the state, likely the Syracuse area) which will be held from 8:30 am until 5:30 pm - tentatively scheduled for April 28 and 29, 2020.

Learning Community Activites*

YES, I am happy to participate in activities designed to support the initial learning community of 25 individuals in becoming certified to train speakers. These may include one or two face-to-face events in New York during the course of the first year after the initial training in April, and may also include telephone or internet-based opportunities to learn from the 24 other people who are becoming ACE Interface Master Trainers as part of the learning community that will be formed following the training in April, 2020.

Application Questions

How would you describe your previous experience with presenting to groups?*

Please briefly describe:*

How would you describe your previous experience with training/teaching/coaching others?*

Please briefly describe:*

How would you describe your previous experience using audio / video equipment such as: PowerPoint, a laptop, microphone, and a projector?*

Comment:*

What is your previous experience with the NEAR science bundle?*

Comment:*

Short response upload

File - Please upload your Short responses document here.*

Max. file size: 10 MB.

About You

Diversity is important to us. All questions are optional, but we urge you to please consider offering as much information as you are comfortable providing. We would like to select representatives across many backgrounds, sectors, and groups. Please check all boxes that you feel apply to your professional self. Please circle any items you feel you have strong personal connection, relationship, or affiliation with.

Sector

Other - please specify

Which of these sectors do you have a have strong personal connection, relationship, or affiliation with? If none, please leave blank.

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Current Field or Past Experience

Other - please specify

Which of these do you have a have strong personal connection, relationship, or affiliation with? If none, please leave blank.

Specialized Training, Skills, & Talent:

Other - please specify

Which of these do you have a have strong personal connection, relationship, or affiliation with? If none, please leave blank.

Gender:

What ethnic community(s) do you identify with?

Are there communities that you have great “reach” into?

Do you speak a language other than English? If so, what language:

We are looking for individuals who are committed to educating others to present the materials as well as doing presentations themselves.

Will you have the time to support people to become ACE Interface Speakers?

Yes
No

ACES 2020

Attendance:Please affirm that you are able to attend the full two-day training and other applicable activities/meetings/events below:

Application Questions

Short response upload

About You