Database Information Sheet

Please complete the following information for the University Training Center's Reading Recovery Database and submit as soon as possible.

Name:
    Include former name in brackets if your name has changed from last year

This year's N.D.E.C. Site Code: (Ask your Teacher Leader for list)

Contact Information
(only if changed from last year or if you are new)

Home Street Address:

Home Town/City:

Home State:     Home Zip Code:     Home Phone:

E-mail Address (only one, please):

Reading Recovery Teaching Information

Name of school(s) where you will pick up Reading Recovery students from during this school year:

First School*:     Second School:

Third School:     Fourth School:
    *If you teach Reading Recovery at more than one school, correspondence from the University will be sent to the school listed first.

In Training Teachers Only
Check box if you are in training this year:

RR Teachers New to Maine (who were trained outside of Maine)
Year your Reading Recovery training was completed (if you were trained in Maine, leave blank):

Professional Development Training/Other Teaching Roles
Check all that apply:

Thank you for helping us keep our files up to date and accurate.