APPLICATION: ASPIRING LEADERS (TIER I) PROGRAM Administrative Apprenticeship Application Form 2007 – 2008 Instructions: Complete and sign this form, attach narrative response as noted below, include the two confidentially sealed references, a copy of your CBEST card, a copy of your California Teaching Credential and send to: The Educational Leadership Development Academy, University of San Diego, School of Leadership and Education Sciences, 5998 Alcala Park San Diego, CA 92101 by May 8, 2007. I. General Information Name:______________________________________________________________ (Please list any additional last names that may appear on transcripts) Social Security Number:
Birth Date:
Work Location:
Position:
Home Phone - include area code: Work Phone - include area code: E-mail 1.) E-mail 2.) Home Address:__________________________________________________________
Years with Current District:
Years of Teaching Experience:
Please indicate how you came to apply to this program: ___Approached by supervisor ___Learned of program from other sources (USD web site, colleagues, etc.). II. References List your current supervisor, individual who completes your performance evaluation, and previous supervisor if current supervisor has been supervising you for less than six months, and one other former coach or supervisor. IMPORTANT NOTE: A copy of the attached reference cover letter and reference form is to be given to each referent. The applicant is responsible for returning the confidentially sealed and signed envelope with the application by the due date.
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1. Current Supervisor Name:
Work Location:
Position:
2. Previous Supervisor (if current supervisor has been supervising you for less than 6 months)
Name:
Work Location:
Position:
3. Former Coach/ Supervisor Name:
Work Location:
Position:
III. Professional Development: List professional development activities and leadership courses/workshops that you have participated in. Workshop or course Date(s) Location
III. Written Narrative. Please attach your response to the following. Please answer each question.
A. Why you would like to participate in the Aspiring Leaders Program. B. How your background and experience qualify you for the program. C. The successes you’ve had as an educator thus far. D. The skills and knowledge you think are needed to become an effective school leader. Narrative format guidelines: Font: Font size must be clear and legible, no less than 10 pt. Pages: Double-spaced, U.S. Letter size. Maximum number of pages: Four, one-sided, with your name clearly showing on each page. Failure to follow these guidelines will result in your application being disqualified. Applicant Signature ________________________________________________Date__________________
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REFERENCE COVER: Aspiring Leaders (Tier I) TO: DESIGNATED REFERENTS OF EDUCATIONAL LEADERSHIP DEVELOPMENT ACADEMY ASPIRING LEADERS PROGRAM CANDIDATES FROM: Ann Van Sickle, Executive Director Educational Leadership Development Academy USD School of Leadership and Education Sciences 5998 Alcala Park San Diego, CA 92110 Telephone: (619) 260-7707 Fax: (619) 260-7851 We are now in the process of identifying the next cohort of administrative apprentices. As the immediate or former supervisor/coach of an interested educator, we are seeking your input (attached). We will be selecting educators who have knowledge of and consistently demonstrate successful instructional practices and who have the talent and ability necessary to lead schools successfully. It is extremely important that you be as honest and as candid as possible in your evaluation of the candidate’s potential to serve as a future site leader. References will be strictly confidential. This office will honor the confidentiality of references; and trusts and expects that you will not share your ratings with the candidate.
IMPORTANT: Please complete the attached form and return in a confidentially sealed and signed envelope to the applicant requesting your reference. Applicants will return your reference to this office along with their application.
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REFERENCE FORM: Aspiring Leaders (Tier I)
EDUCATIONAL LEADERSHIP DEVELOPMENT ACADEMY REFERENCE FOR ASPIRING LEADERS PROGRAM CONFIDENTIAL Applicant’s Name: _____________________ Referent’s Name: _______________________ Referent’s Work Location: ________________________
PLEASE COMPLETE AND RETURN TO THE REQUESTING APPLICANT IN A CONFIDENTIALLY SEALED AND SIGNED ENVELOPE. Your cooperation is requested to ensure this reference is returned in a timely manner. A candidate's status is dependent upon your timely response. Please provide a brief narrative about this candidate. Include your knowledge of this person as a “leader” and a “teacher of children and/or adults.” Please be sure to discuss their skills of pedagogy, coaching and interpersonal skills. This is not necessarily a recommendation form - it is a “narration” to get an honest assessment of this candidate. Your signature below indicates that you completed this form to the best of your knowledge and that you agree to keep this reference confidential.
_________________________________________ _______________ Signature Date
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