Transformative Praxis Center Application Form

Thank you for your interest in E-SToPP’s mission and vision of transforming teaching and learning cultures across systems. To schedule one of E-SToPP’s collaborative teacher education and professional development opportunities at your location, please complete, sign, and return this Transformative Praxis Center Application Form to debrapane@e-stopp.org.

Your Name

Affiliation/Location

Please Enter Your Address Below :

Address Line 1 : Address Line 2 (optional):

City: State:

Zip1:

Your Email:

Phone (Format:XXX-XXX-XXXX):

Signature: (required):

Date: (required):

Education major practicum(s) :


Teacher education workshop(s) :

Professional development seminar(s):


Positive Peer Leadership Mentoring (PPLM) Workshops :

How many participants are interested in attending? :

We will contact you upon receipt of this application form to schedule your collaborative practicum(s), workshop(s), or seminar(s).

DEBRA MAYES PANE, PhD
E-SToPP Founder & President