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Official Seal of the California Department of Education


2020 Health Education Adoption of Instructional Materials
Application to Serve on the Review Panel

Curriculum Frameworks & Instructional Resources Division

Applications must be received by 3 p.m. Thursday, August 15, 2019.
The California Constitution, Article 9, Section 7.5, and the California Education Code Section 60200 authorize the State Board of Education (SBE) to adopt instructional materials for kindergarten through grade eight.

The SBE and the State Superintendent of Public Instruction are seeking candidates to serve on review panels for the 2020 Health Education Adoption of Instructional Materials. Panel members will evaluate instructional materials for use in kindergarten through grade eight, inclusive, that are aligned with the
Health Education Content Standards for California Public Schools.
Each panel will consist of multiple instructional materials reviewers (IMRs) and at least one content review expert (CRE). IMRs and CREs serve as advisors to the Instructional Quality Commission (IQC) and the SBE in the review of instructional materials submitted for adoption. A majority of IMRs, as stated in regulation (California Code of Regulations, Title 5 [5 CCR] Section 9512), shall be teachers who teach students in kindergarten to grades one through twelve, have a professional credential under
California law, and who have experience with, and expertise in, standards-based educational programs and practices in the content field under consideration. At least one such teacher shall have experience in providing instruction to English learners, and at least one such teacher shall have experience in providing instruction to students with disabilities. Other IMRs may be administrators, parents, local school board members, teachers not described above, and members of the public. CREs are required to hold a doctoral degree in health or a related discipline.
Panel members will attend a four-day training in Sacramento on April 21-24, 2020. They will review instructional materials independently at home and will the reconvene in panels for up to four days of deliberations on July 21-24, 2020, with the preparation of a report to the IQC. IMRs and CREs will receive their actual and necessary travel expenses for attending the training and deliberation session activities. Travel and per diem costs are reimbursed at standard state rates; however, no stipend or substitution pay is provided.

Following are the instructions and information that will be collected in an online form.
All questions are required unless specified optional.
Applicant Information
1.Position on the Panel
2.Area of Expertise Select the one that applies to your current position.
3.Grade Levels of Expertise (select all that apply)
4.Years Teaching
5.Experience Teaching English Learners. Have you provided instruction to English learners?
6.Experience Teaching Students with Disabilities. Have you provided instruction to students with disabilities?
7.Highest Degrees/Certifications List your four highest academic degrees and/or certifications, including those specific to health education, and the awarding institution. List your highest achievement first.
Relationship with Publishers: Conflict of Interest Disclosure Statement
Your answers below will serve as the disclosure of certain information as required by the "Statement of Activities that are Inconsistent, Incompatible, or in Conflict with Duties of a Member of an Educational Policy Advisory Commission or a Committee or Panel Thereof," as amended January 1978, and
5 CRR Section 18600. Your answers will be the basis for eligibility ruling in the event some activity appears to be incompatible, or in conflict with the duties assigned.

For the questions below, "immediate family" is defined as your spouse and dependent children (California
Government Code Section 82029).
11.Question 1 Do you or a member of your immediate family have, or have you had, a business relationship at any time over the past 12 months with a publisher that produces instructional materials for California?
12.Question 2 Are you currently employed by or under contract to, any person, firm, or organization which will do business with or submit instructional materials to the California Department of Education (CDE)?
13.Question 3 Have you ever been employed by or had any other kind of contractual relationship with any person, firm, or organization doing business with, or submitting instructional materials to, the CDE? .
14.Question 4 Do you expect to receive any royalty payments during your period of service on the advisory committee?
15.Question 5 Were you or a member of your immediate family an author, contributor, or editor of (or consultant on) any textbook, other curriculum material, or project proposal that is likely to be submitted to the CDE?
16.Question 6 Have you received compensation, do you expect to receive compensation, or do you have any other kind of contractual relationship with any organization that is either a subsidiary, parent organization, or "sister organization" of any entity which will do business with your advisory body or will submit materials to your advisory body?
17.Gender (optional)
18.Ethnicity Please select all that apply from below. (Optional)
19.Applicant Acknowledgement
20.Applicant Certification #1
21.Applicant Certification #2
22.Applicant Certification #3
Supervisor/Employer Information
When you submit your application form, a message will be automatically sent to the employer's email address you enter above.
23.Professional References #1
Please provide the names and contact information for at least one and up to three professional references.
24.Professional References #2 (Optional)
25.Professional References #3 (Optional)
Attach a resume by pressing the button below next to the box. Browse the location of your resume and click attach. The only accepted file formats are doc, docx, pdf.
IMPORTANT: Do NOT rename the attached file or type your name where the attached file name appears.
Once you select the "Submit" button below, your application responses will be sent to the California Department of Education and you will be redirected to the Health Education web page. You will receive a confirmation email from Surveys at CDE. You may need to check your spam folder for this email.

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