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Application for the Second Look Educator Program

Section 1 About You

What is your first name?

What is your last name?

What is your email address?

State or Province?

Section 2 Professional Information

Institution Name

Your Position

If other then please describe.

Institution Type

If other then please describe.

Institutional Website (Optional)

Section 3 Areas of Interest (Optional)

Which subjects most interest you?

If other then please describe.

This helps us improve recommendations in the future.
Section 4 Grade Levels

Which learners do you primarily work with?

If other then please describe

Section 5 Verification
Use the verification process you would like. You must choose at least one.

Educational Email

Documentation Upload (PDF, JPG, PNG)

Manual Review.

Please briefly explain your educational role and why manual verification is appropriate.
Section 6 Additional Information (Optional)

Is there anything else you would like us to know while reviewing your application?

Section 7 Applicant Agreement

I certify that the information provided in this application is accurate to the best of my knowledge.

I understand that approval is based upon verification of eligibility.

I understand that this program is intended for qualifying education professionals and that Second Look may request additional verification if needed.