Dar al Islam Teachers Institute

Institute Application
 
BACKGROUND INFORMATION
*Username:
*Password:  (Must be 7 characters long.)
*First Name:
*Last Name:
*E-mail Address:
Optional 2nd E-mail:
Permanent Address:
City:
 State:  Zip:
Home Phone:
Mobile Phone:
 
SUMMARY OF PROFESSIONAL INFORMATION
Name of Instituition for which you work:
 
Address:
 
Type of Institution:
If Other, explain:
 
Additional Description of Institution:
 
Pertinent Courses you currently teach:
 
Other Professional Activities (i.e. working groups or boards, curriculum developement):
 
Professional Development you have led (if none, simply write n/a):
 
SUPPORT DOCUMENTATION
Upload current resume (limit to 2 pages):

 
Upload two letters of reference, including one from your supervisor or head of your institution:


 
Upload description of professional responsibilities (please limit to 200 words):

 
Upload an essay (limit to one typed page) - Describe why you are interested in attending the Dar al Islam Teachers' Institute and how participating in it will complement and enhance your current professional role and personal goals:


I hereby understand that by submitting this application I acknowledge Dar al Islam's right to document the Teachers' Institute as it deems appropriate and use the materials, including my likeliness and testimonials, to further its educational objectives.

You may return later to make additional changes.
You cannot return after it's submitted.