Please fill out this form to help us finalize our plans for the HS Leadership Initiative next school year. Please note that the information you provide is preliminary and will help us finalize our contract and determine costs. Currently, we estimate the cost per participant for next school year will be $200. In the fall, we will open up a registration site using Title IIA funds, and ask you to provide names and email addresses of participants. If you have any questions while filling this out, feel free to contact Kaitlyn directly at Kaitlyn.oleary@seattlearch.org or 206-274-7655. Thank you!

Kindly complete this form no later than May 31, 2019.

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* 1. Name

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* 2. School or Department

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* 3. Your Position:

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* 4. Name of primary school contact for HS leadership work

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* 5. Email address of primary school contact

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* 6. Next year we are building in some more administrator- specific learning opportunities with the goal of supporting you as you lead implementation of this work at your local school sites. These are geared towards your school lead for this project. Administrators will be welcome to bring 1-3 participating teacher leaders to any of the sessions below. Please check all of the sessions the primary administrator will participate in next year:

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* 7. Please check all of the dates on which the primary administrator is available for the above opening and closing sessions

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* 8. Cohort 1 will participate in 3 half-day sessions next year, focused on engaging in cycles of inquiry in content teams. They will also learn strategies to lead inquiry-based departmental goal setting. Please indicate the estimated number of cohort 1 members who will participate in the program next year.

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* 9. Please check all of the dates on which cohort 1 members will be available for the above sessions

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* 10. Cohort 2 will participate in 2 half day learning walks with cohort 3 next year. Please indicate the estimated number of cohort 2 members who will participate in the program next year.

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* 11. Cohort 3 will participate in1 full day opening session and 2 half day learning walks with cohort 2 next year. Please indicate the estimated number of cohort 3 members who will participate in the program next year.

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* 12. Please check all of the dates on which cohort 2 and cohort 3 members will be available for the above sessions.

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* 13. In addition to all of the above learning opportunities, CEL is offering site-based support. They recommend two half-day sessions on site at your school. These could be used for school-wide professional learning, learning walks with your department chairs, or leadership team planning. The total cost for two sessions is $3,150. If your school decides to pursue this option, we would help you create an individual contract with CEL, and you could customize the visits to meet your school needs. Do you want to participate in this additional learning option for next school year?

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* 14. Are there any additional support structures that you feel would be helpful for you as an administrator as we continue our work with CEL next year?

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* 15. Additional Questions/ Comments

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