APPLICATION: ASPIRING LEADERS (TIER II) PROGRAM Application Form 2008 – 2009
Please fill out, sign, and include: * Copy of CBEST * Copy of CLEAR Teaching Credential * Verification of Employment * 1 letter of reference * Official Transcripts * $45.00 Fee * Copy of Preliminary Administrative Services Credential
I. General Information Name:______________________________________________________________ (Please list any additional last names that may appear on transcripts) Social Security #: Birth Date: Tier I ELDA Graduate: Y or N Graduation Year: Work Location: Position: District: Home Phone - include area code: Work Phone - include area code: E-mail 1.) E-mail 2.) Home Address:__________________________________________________________ II. References List your current supervisor (individual who completes your performance evaluation). 1. Current 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
Applicant Signature ________________________________________________Date__________________
1
REFERENCE COVER: Aspiring Leaders
TO: DESIGNATED REFERENTS OF EDUCATIONAL LEADERSHIP DEVELOPMENT ACADEMY ASPIRING LEADERS PROGRAM CANDIDATES FROM: Melinda Martin, Director Educational Leadership Development Academy USD School of Leadership and Education Sciences 5998 Alcala Park San Diego, CA 92110 Telephone: (619) 260-8839 Fax: (619) 260-7851 We are now in the process of identifying the next cohort of administrative credential candidates. As the immediate supervisor/coach of an interested educator, we are seeking your input (attached). We are 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.
2
REFERENCE FORM: Aspiring Leaders (Tier II)
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
3