USIBEF

“Where primary education improves, tolerance and economic opportunity can be found.”

Please print these pages.  Carefully fill out the following application to the best of your ability.  Send it, along with your current resume and appropriate fees of $50 USD to:   Dr. Lawrence Gundersen, 20 Northshore,  Jackson, TN 38305 (USA).  Please make checks payable to:  USIBEF.

Application

I, _________________________(print your name),  agree to release any and all my private information to USIBEF in relation to police background checks for the application to membership in USIBEF.  Information obtained by USIBEF’s governing body will be used to determine my suitability for the task of either directly or indirectly supporting the mission and goals of USIBEF.  And, I understand that there will be no refunds to denied applicants.

____________________________ (signature)                   __________________ (date)

 Student  Membership                                                         
 Foundation Membership

Highest Degree:  Associate
 Baccalaureate  Master’s  Doctorate

Teaching/Specialty Area(s): __________________________________________________

Teaching/Coaching/Admin. Experience:_________________________________________

Dates -

Places -

(attach resume/vita)

 

 Student Member

(attach a three hundred word essay on what you would do with a large class of fifth grade students on the first three days of class, and why you would be the most capable of performing that task)

 Foundation Member

(attach a note explaining how you plan to support the mission and goals of USIBEF, and of how you would like your membership fees to be planned and directed)

In an effort to better select candidates and sponsors, I understand that the following information may be used only by USIBEF’s leadership to determine suitability for membership or sponsorship.   I understand that this information will NOT be shared with any third parties, marketers, and/or promotions/promoters:

Date of Birth __________________________________

Place of Birth__________________________________

Social Security Number__________________________

Signature _____________________________________  Date _______________

SEND APLLICATION PACKET AND FEES TO (make check out to USIBEF):

Lawrence Gundersen, Ph.D.

Professor of History and Political Science

20 Northshore Dr.

Jackson, TN 38305