2013-2014 Application for NYS Albert Shanker Grant Program


  • Before submitting this application, please carefully read the Guide to National Board Certification at: www.nbpts.org/userfiles/file/guide_2013_web.pdf
  • Complete the 2013-2014 National Board for Professional Teaching Standards (NBPTS) Candidate application online at www.nbpts.org.
  • An applicant for the Albert Shanker Grant must first register as a candidate with NBPTS and pay the required registration fee to the National Board. 
  • The Albert Shanker Grant Program application should be submitted by November 30, 2013.  You must also send to us verification that the NBPTS registration fee has been paid.  Please mail or FAX verification to:

NYS Education Department, Office of Teaching Initiatives
Attn: Albert Shanker Grant Program
89 Washington Avenue, Room 5N-EB
Albany, NY 12234
FAX #: (518) 473-0271, Attn: Albert Shanker Grant Program

* Denotes a required field

Candidate Information
* First Name:
* Last Name:
* Maiden Name:
Please provide your maiden name or type Not Applicable in the text box.
*Last 4 Digits of SSN
Please provide the last 4 digits of your SSN.
*Date of Birth
(MM/DD/YYYY format)

Phone Number:
* Home:
() -
* Cell:
() -

* Email Address:
* National Board Candidate ID Number:
* Are You a NBCT Take One! Candidate?
Yes No

Home Address
* Street 1:
Street 2:
* City:
* State:
* Zip Code:

Employing NYS Public School District Information

* Name of NYS Public School District:
* Superintendent Name:
* School Building:
* School Address - Street 1:
School Address - Street 2:
* City:
* State:
* Zip Code:
* School Phone Number:
() -
* School Email Address:

NYS Teacher Certification Information – List type, title, and grade level for all certificates held

Please Note: Enter this information all on one line. Do not press the enter button to create multiple lines.
* Certificate 1:
  Certificate 2:
  Certificate 3:
  Certificate 4:
  Certificate 5:

Online Affidavit

Read all statements, check all boxes and then click on the “Sign Affidavit” button:
* I have paid the required initial registration fee to the NBPTS.
* If I withdraw my candidacy, I understand that I am responsible for repayment of any grant funds not recovered due to my early withdrawal.
* I do not have additional third-party support applicable toward the NBPTS application fee.
* I agree to remain employed in a NYS public school district for at least one year after receiving National Board Certification.
* I am employed and TENURED as a full-time teacher in a New York PreK-12 Public School.
By SIGNING this affidavit, I hereby certify that all of the information I provided in this online application is true and contains no misrepresentation or falsehoods and is signed under penalty of perjury.

By clicking the “Sign Affidavit” button you are submitting the NYS Albert Shanker Grant application.


Last Updated: August 20, 2013