Application for the Keep America Beautiful National Representative

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STATEWIDE CURRICULUM TRAINER APPLICATION Name Address City __________________________Texas Zip _______________County ______________________________ Work Phone Fax Occupation Title Describe your formal education including degrees, certificates and accreditations: Associates Degree ___________________________College _________________________________________ Bachelor's Degree: Major ___________________________Minor_____________________________________ University or College ________________________________________________________________________ Master's Degree _____________________________________________________________________________ University or College ________________________________________________________________________ Certificates or Accreditations __________________________________________________________________ Have you participated in a Waste In Place workshop? Yes No (please circle) On a separate sheet please answer the following questions: Describe your informal education experience that would qualify you for a trainer position. Describe your association with Keep America Beautiful, Keep Texas Beautiful, or local affiliate including your membership in KTB or a local program. Describe previous experience conducting workshops. Describe your experience with environmental education, curricula and knowledge of subject matter including integrated solid waste management. Describe your current employment arrangement with regard to flexibility to conduct workshops, specifically, when would you be available to conduct workshops i.e. days, evenings, weekends? What is your familiarity with Texas laws as they affect education, including TEA policies and procedures and TEKS. Please submit a resume and two references on your training skills or association or your affiliation with a local KAB/KTB program. Home Phone Email KEEP TEXAS BEAUTIFUL STATEWIDE CURRICULUM TRAINER APPLICATION Keep Texas Beautiful, Inc. a statewide non-profit organization, with a mission to educate and engage Texans to take responsibility for improving their community environment, is recruiting individuals to implement environment education training in Texas. The Keep America Beautiful curriculums Waste In Place (Grades K-8) has been used in Texas for more than two decades. If selected, the Trainer will be responsible for and agree to the following:           Participate in "train the trainer" workshop. Assist in "student teaching" workshop after completing the "train the trainer" workshop. Inform Keep Texas Beautiful of all workshops and those teachers trained in order to receive state credit. Report on all workshops using pre-approved forms, agendas, etc. Submit evaluation forms completed by workshop attendees. Agree that any trainer fee and reimbursement will be based on the fee and reimbursement schedule approved and provided by Keep Texas Beautiful. Agree to wait for approval by KTB before receiving payment for training. Approval will be based on submittal of all required documents. Agree to train on a statewide basis with emphasis on the region where s/he lives. Follow policy from Keep America Beautiful's Policy Statement for use of KAB Curricula. Not use workshops as a forum to express personal environmental opinions. The KTB/KAB policy is to provide information for individuals to take personal responsibility. I have read the information above and agree to follow these guidelines. I understand that I will receive additional information at the "Train the Trainer" session if I am selected. I understand that travel to the training session(s) and the accommodations during the training session(s) will not be covered by Keep Texas Beautiful. Signature: _________________________________ Date: __________________ Keep Texas Beautiful, Inc. Trainer Application 1524 South IH-35, Suite 150 Austin, Texas 78704 For more information contact 1-800-CLEAN-TX or (512) 478-8813.

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