• NBCT Forms

     ALL active NBC Teachers whether submitting hours or not, must submit the following in order to be eligible for the monthly differential and/or NBC 92 hours compensation:

    • To be submitted annually by the due date and whenever a change of assignment to another school or class code occurs. 
    • Due Dates:    1st Semester--September 29, 2017;    2nd Semester February 9, 2018 (for newly certified NBC teachers only)
    • fax Principal Assignment Certification (PAC) to 241-5494  Attn Carla Givens  
     Commitment Form/Action Plan Information (combined in one document)
    • To be submitted annually by all active NBC Teachers, whether submitting hours or not
    • Confirmation emails will be sent weekly during the submission window and a few weeks prior to log due dates.  
    • Please remember that NBC Teachers may not earn hours past the 30 hours for Early Start until these documents are received for the new school year.  Get them in as soon as you can!
    • Action Plan Approval
      • Remember!  Task 10 ALWAYS requires written pre-approval from your NBC Liaison or Director
      • email aleeta.powers@lausd.net if you have an urgent need for a Task 10 response prior to receiving confirmation of approval status 
    • Action Plan Updates  click for information


    NBC Teachers who are submitting hours for compensation only:

    Click on image to access 
     17 18 LOG
       17 18 1st Sem Hrs OV
    required when submitting logs in December
               link available in November--include all hours REPORTED for first semester
       17 18 2nd Sem Hrs OV
    required when submitting logs in May
                link available in April--include all hours REPORTED for second semester (even if completed in first semester)
     The online overview form is to be completed to reflect hours actually completed each time you submit your NBC log.

    17 18 Mentor LOG --Online--click here to go to log form


    NBC Logs--URGENT!  All posted guidelines must be followed   See the guidelines page for more information.

    Completing service hours is optional.  NBC Teachers may elect to complete anywhere from 0 to 92 of the hours.  The 7 1/2% differential will reflect the number of eligible hours served and submitted following guidelines.
    • Where do I submit my logs?   Please remember that logs are legal documents and should be completed accurately following all legal and ethical guidelines.
    • 333 S. Beaudry  LA CA 90017  Teacher Support Unit  14th floor  Attn: Ana Garcia
    • Due Dates (you have the choice of submitting logs in December, May, both or neither--it is entirely your choice)
      • 1st Semester--December 8, 2017 (continuing NBCTs Only)
      • 2nd Semester--May 11, 2018 (Continuing)   May 18, 2018 (Newly Certified)   Dropoff available at Liechty MS Wilshire Parking Lot on 5/12/18 9-11 am or after the last session attended at Liechty TLL conference that day
    • Put Log pages in this order:
      • Completed Coverpage
      • Complete Activity Log Overview
      • All Task 1-10 Log pages Together
      • All Task 1-10 Evidence, Tabbed by Task  (no more, no less than asked for in the guidelines)

    Please complete the information at this link to alert us of changes in personal information or assignment.


    The following forms need to be submitted by teachers with special circumstances (COMING SOON):

             email your Local District NBC representative if you have a change in status 
    • The CHANGE IN STATUS form is required for teachers who will leave or rejoin eligibility for NBC compensation (change in position, leave of absence, retirement, etc.)
    • The INFORMATION  UPDATE form is required for teachers who need to share important changes such as address or name changes.