ILA National Recognition
Application and Payment

HOW TO COMPLETE THIS FORM

To submit a new application:

Choose New application for self-study in the Payment Information section below.

ILA will send a confirmation email with payment instructions to the email address provided below.

To resubmit a self-study:

Choose Resubmission of self-study in the Payment Information section below.

ILA will send a confirmation email with payment instructions, additional information, and next steps to the email address provided below.

APPLICATION INFORMATION

* Required Information

Date Submitted * +

Name of Institution *

Billing Address

Department *

Address *

City *

State *

Zip/Postal Code *

Billing Contact Name *

Billing Contact Email *

Confirmation of Email *

ELEMENTARY/INTERMEDIATE CLASSROOM TEACHER PREPARATION PROGRAM

Please complete this section for the Elementary/Intermediate Classroom Teacher Preparation Program.

Report Preparer Contact

First Name

Middle Name or Initial

Last Name

Professional Title

Telephone

Home

Work

Mobile

Email

Confirmation of Email

Name of Program(s) to Be Submitted

+-

Self-Study Review Cycle (choose one)

Spring (self-study due March 1)

Fall (self-study due October 1)

Review Year *

READING/LITERACY SPECIALIST PREPARATION PROGRAM

Please complete this section for the Reading/Literacy Specialist Preparation Program.

Report Preparer Contact

First Name

Middle Name or Initial

Last Name

Professional Title

Telephone

Home

Work

Mobile

Email

Confirmation of Email

Name of Program(s) to Be Submitted

+-

Self-Study Review Cycle (choose one)

Spring (self-study due March 1)

Fall (self-study due October 1)

Review Year

PAYMENT INFORMATION

NEW APPLICATION FEE - STAGE I

New application for self-study, 1 program, $500

New application for self-study, 2 programs, $1,000

RESUBMISSION FEE - STAGE I

Resubmission of self-study (per occurrence), 1 program, $0. Programs to resubmit the requested minor revisions/specific information requested by reviewers within 30 days.

Improve Program Fundamentals/Resubmit, $375. Programs that receive this decision are advised to review ILA peer feedback in the Team Report and to resubmit the entire self-study package.

EXTENSION FEE - STAGE I

Extension fee for additional time to complete self-study (if needed), $150

NATIONAL RECOGNITION FEE

A national recognition fee is required to maintain ILA National Recognition status. You will be required to pay a national recognition fee of $500 when your STAGE I self-study is approved and on that date every year thereafter.

Please look for an email from ILA containing payment instructions within 1–2 business days (make sure to check your spam folder).

Please contact ilanationalrecognition@reading.org with any questions.

If you would like to retain a copy of this form for your records, please print it before clicking Submit.