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Application for NYS Albert Shanker Grant Program


Before submitting this application for the Albert Shanker Grant Program you must:

Pay the annual NBPTS registration fee and register and pay for your first component.

This Albert Shanker Grant Program application must be submitted by February 16, 2024.

Step 3 of the online application: Verification must be submitted and include:

A copy of the Registration Receipt with NBPTS; and
A copy of the Payment Receipt for the First component.

Please email verification to:

After completing this form please check the email you provided for a confirmation of your submission.

* 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.

*Birth Year:

Your Contact Information:

*Home Phone:

*Cell Phone:

*Candidate ID:

Home Address

*Street 1:

Street 2:



*Zip Code:

Employing NYS Public School District Information

*School District:

*School Superintendent Name:

*School Name:

*School City:

*School Street 1:

School Street 2:

*School State:

*School ZIP Code:

*School County:

*School Phone:

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:

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.