Inspired Leaders Principal Licensure Prgram PROGRAM APPLICATION Applicatin Submissin Prcess: Submit the fllwing t the Center fr Educatinal Leadership: Prgram applicatin Experience Verificatin Frm Tw Current Prfessinal letters f recmmendatin (written specifically fr admissin t the prgram) Unfficial cpies f transcripts Essay respnses Resume Prgram applicatin and ther materials shuld be emailed t center_edleadership@csuhi.edu, faxed t (216) 687-5378, r mailed t: Inspired Leaders Principal Licensure Prgram Center fr Educatinal Leadership Cleveland State University 2121 Euclid Avenue, JH 275 Cleveland, OH 44115 Upn review f yur applicatin materials and transcripts, the Acceptance Cmmittee will select applicants t interview fr the Inspired Leaders Principal Licensure prgram. Acceptance decisins int the prgram will be made by a representative grup f CSU Faculty. Ntificatin f yur status int the prgram will be e-mailed and mailed by the Center. Upn acceptance int the Inspired Leaders Principal Licensure Prgram, yu will be recmmended fr admissin int the Cllege f Graduate Studies. Further infrmatin n hw t apply t the Cllege f Graduate Studies will be prvided. Inspired Leaders Principal Licensure Prgram Applicatin 1
Inspired Leaders Principal Licensure Prgram PROGRAM APPLICATION Lcatin: CSU Main Campus Medina ESC Cuyahga ESC Applicant Prfile First Name: Preferred First Name: Last Name: Maiden Name: Birthday: Title/Psitin: Number f years in current psitin: Schl/Organizatin: Schl/Organizatin Address: City: State: Pstal Cde: Business Phne: *Business Email Address: *Persnal Email Address: Hme Address: Business Fax: City: State: Pstal Cde: Hme Phne: Previus Jb Title: Number f years in previus psitin: Number f years teaching: Number f years in administratin: Cell Phne: Middle Initial: Primary Email Primary Email As a matter f plicy, Cleveland State University des nt discriminate amng applicants f participants n the basis f race, religin, gender, natinal rigin, r handicap. Supplying the fllwing infrmatin is ptinal. African American Latin/a Female Asian American Native American Male Caucasian Other * Bth email addresses are required Inspired Leaders Principal Licensure Prgram Applicatin 2
Please answer the fllwing questins regarding yur academic experience. Educatin (Please list mst recent first.) Undergraduate: Cllege r University Field r Majr Year Cmpleted Cllege r University Field r Majr Year Cmpleted *Graduate: Cllege r University Field r Majr Year Cmpleted Cllege r University Field r Majr Year Cmpleted Are yu currently enrlled in CSU? Yes N If ever enrlled, what is yur CSU ID? Inspired Leaders Principal Licensure Prgram Applicatin 3
Other Academic Infrmatin Have yu taken either the GRE r MAT exams? Yes N Scre: Are yu licensed t be a schl teacher? Yes N Other: Have yu ever applied t CSU s Cllege f Graduate Studies? Yes N Accepted What ther licensure d yu hld? Is there anything else yu wuld like t tell us abut yur academic backgrund? Hw did yu hear abut this prgram? ***Please nte that BCI/FBI backgrund checks (that are less than 5 years ld) are required when yu apply fr yur principal s license. This is required t be endrsed thrugh Cleveland State University. Inspired Leaders Principal Licensure Prgram Applicatin 4
Essay Questins: Please answer the fllwing five questins using a separate dcument and include yur name n each page. 1. Describe yur schl r wrk rganizatin (i.e. prgrams, educatinal values, schl imprvement plans, etc.). 2. a. Why did yu becme an educatr in the first place? b. What d yu stand fr as a leader? c. What legacy d yu want t leave? 3. List any prfessinal rganizatins t which yu currently belng r institutes yu have attended during the past year. 4. List all current licensure yu hld as well as any licensure that has expired and any licensure yu are currently in the prcess f receiving. 5. Describe hw yur leadership wrk r capabilities aligns t the ne f the fllwing Interstate Schl Leaders Licensure Cnsrtium (ISLLC) standards r cmpetencies fr principal perfrmance. Standard 1: Visin An educatin leader prmtes the success f every student by facilitating the develpment, articulatin, implementatin, and stewardship f a visin f learning that is shared and supprted by all stakehlders. Standard 2: Instructin An educatin leader prmtes the success f every student by advcating, nurturing and sustaining a schl culture and instructinal prgram cnducive t student learning and staff prfessinal grwth. Standard 3: Resurces/Safety An educatin leader prmtes the success f every student by ensuring management f the rganizatin, peratin, and resurces fr a safe, efficient, and effective learning envirnment. Standard 4: Cmmunity An educatin leader prmtes the success f every student by cllabrating with faculty and cmmunity members, respnding t diverse cmmunity interests and needs, and mbilizing cmmunity resurces. Standard 5: Ethics/Integrity An educatin leader prmtes the success f every student by acting with integrity, fairness, and in an ethical manner. Standard 6: Educatinal Cntext - An educatin leader prmtes the success f every student by understanding, respnding t, and influencing the plitical, scial, ecnmic, legal, and cultural cntext. Center fr Educatinal Leadership Cllege f Educatin and Human Services Cleveland State University 2121 Euclid Avenue, Julka Hall 275 Cleveland, Ohi 44115 (216) 875-9912 Fax (216) 687-5378 www.csuhi.edu/centerfredleadership Inspired Leaders Principal Licensure Prgram Applicatin 5
ORGANIZATIONAL LEADERSHIP AND INSPIRED LEADERS EXPERIENCE VERIFICATION FORM Candidates fr Principal Licensure must hld a master s degree and have tw years f experience in a schl setting at the age levels fr which the principal license is sught. This prgram is nt a path fr receiving a teaching license. ODE apprves hiring principals withut a teaching license, but each schl district may have its wn plicy. Name: CSU ID: Please cmplete the fllwing: License(s) yu are seeking: Principal Grades PK-6 Principal Grades 4-9 Principal Grades 5-12 D yu hld a valid Ohi prvisinal, prfessinal, r permanent license r certificate? Yes N If yes, please state the credential(s) yu hld: Emplyment Histry (list mst current emplyer first, use additinal paper if needed): Emplyer: Psitin Held: Grade Level(s) Served in this Psitin: Number f Years at Psitin: Psitin Start Date: Psitin End Date: ***************************************************************************** Emplyer: Psitin Held: Grade Level(s) Served in this Psitin: Number f Years at Psitin: Psitin Start Date: Psitin End Date: Inspired Leaders Principal Licensure Prgram Applicatin 6