Apply to Become a VTS Certified Facilitator VTS Facilitator Certification Application Applicant Information First Name Last Name Phone Email Email TypePersonalWork Address City State/Province (XX) Postal Code CountryPlease select... Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos ( Keeling ) Islands Colombia Comoros Congo Cook Islands Costa Rica Côte d ' Ivoire Croatia ( Hrvatska ) Cuba Cyprus Czech Republic Congo ( DRC ) Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands ( Islas Malvinas ) Faroe Islands Fiji Islands Finland France French Guiana French Polynesia French Southern and Antarctic Lands Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Honduras Hong Kong SAR Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao SAR Macedonia, Former Yugoslav Republic of Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Northern Mariana Islands Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda Samoa San Marino São Tomé and Prìncipe Saudi Arabia Senegal Serbia and Montenegro Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands Spain Sri Lanka St. Helena St. Kitts and Nevis St. Lucia St. Pierre and Miquelon St. Vincent and the Grenadines Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Vatican City Venezuela Viet Nam Virgin Islands ( British ) Virgin Islands Wallis and Futuna Yemen Zambia Zimbabwe Organization Information (if applicable) Organization Website Title Experience Have you applied to be a Certified VTS Facilitator in the past?YesNo VTS Training Experience - these are formal VTS trainings that require online registration (check all that apply)VTS School-based Training ( Year 1)VTS School-based Training ( Year 2)VTS School-based Training ( Year 3)VTS Beginner PracticumVTS Advanced PracticumVTS Coaching Workshop IVTS Coaching Workshop IIVTS Aesthetic Thinking WorkshopVTS Image Selection WorkshopVTS Enrichment Experience (check all that apply)VTS Summer InstituteVTS Online Summer SeriesVTS SoireeVTS Look Club Describe any VTS experience that is not included above Image Discussion #1 Questions VIDEO #1 Paste a link to a YouTube video of your session here Record yourself leading an image discussion (no longer than 15 minutes long). The video of your discussion can be recorded on a phone or GoPro or video camera - any recording device you can access. Be sure we are able to hear you and the group comments. Include your “silent moment to look” in your video. Once you have recorded your video, please upload it to YouTube & provide up the YouTube link to the image discussion video here. Include VIDEO #1 in the title. x What ages were the participants in this session? VIDEO #1 PARTICIPANT DESCRIPTION: VTS EXPERIENCE PARTICIPANT DESCRIPTION: Include any additional information about your participants if appropriate (i.e, special needs students, memory-care/dementia group, etc.) IMAGE SELECTION: Based on your understanding of VTS methods and theory of aesthetic development, what makes the image used appropriate for this particular audience? Remember, we cannot assign a stage to comments provided in an image discussion. We are interested in hearing about your intention behind selecting this image for your specific audience. (250 words maximum) REFLECTION (1): Identify a successful choice in your facilitation. What did you see/hear to make you say that? (250 words maximum) REFLECTION (2): We are interested in understanding how you make choices during facilitation to support students. Select a moment in the discussion, either a paraphrase and/or Q2 (What did you see that made you say...?). Reflect on the student response to your facilitation decision. (250 words maximum) REFLECTION (3): Based on this image discussion, what would you like to work on for next time? (250 words maximum) Image Discussion #2 Questions VIDEO #2 Paste a link to a YouTube video of this session here Record yourself leading an image discussion (no longer than 15 minutes long). The video of your discussion can be recorded on a phone or GoPro or video camera - any recording device you can access. Be sure we are able to hear you and the group comments. Include your “silent moment to look” in your video. Once you have recorded your video, please upload it to YouTube & provide up the YouTube link to the image discussion video here. Include VIDEO #1 in the title. x VIDEO #2 What ages were the participants in this session? VIDEO #2 PARTICIPANT DESCRIPTION: VTS EXPERIENCE PARTICIPANT DESCRIPTION: Include any additional information about your participants if appropriate (i.e, special needs students, memory-care/dementia group, etc.) IMAGE SELECTION: Based on your understanding of VTS methods and theory of aesthetic development, what makes the image used appropriate for this particular audience? Remember, we cannot assign a stage to comments provided in an image discussion. We are interested in hearing about your intention behind selecting this image for your specific audience. (250 words maximum) REFLECTION (1): Identify a successful choice in your facilitation. What did you see/hear to make you say that? (250 words maximum) REFLECTION (2): We are interested in understanding how you make choices during facilitation to support students. Select a moment in the discussion, either a paraphrase and/or Q2 (What did you see that made you say...?). Reflect on the student response to your facilitation decision. (250 words maximum) REFLECTION (3): Based on this image discussion, what would you like to work on for next time? (250 words maximum) Payment Details Certification Fee: $ Discount Code Total Fee (with Discount) $ Join Visual Thinking Strategies! Please add me to the VTS newsletter mailing list Yes I would like to make a donationYes Donation Amount: $ Payment Information Total Amount Due: $ Payment MethodCheck by MailCredit Card Pay by MailPlease send your check to:CommonwealP.O. 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