1.

**Application Dates**

Open Application Period: January 1- March 1, 2013
Application Due Date: March 1, 2013
Notification Period: April 1-May 1, 2013


**Application Checklist**

- This application form
- Essays
- Strengths Survey
(all completed on survey monkey)

**You are able to return and edit the survey after exiting or submitting, providing you use the same computer, and do not clear cookies prior to re-entering. However, we recommend that you complete the survey in one sitting if at all possible.**

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* 1. Name and title

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* 2. Home Address

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* 3. Home Number and/or Cell Phone Number

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* 4. Email

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* 5. School

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* 6. School Address

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* 7. School Phone

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* 8. School Fax

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* 9. List degrees and area of study

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* 10. What are three long-range school-improvement goals for increasing student achievement that you have articulated to the staff and community?

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* 11. In what capacity have you known the Aspiring Principal candidate with whom you are applying? Why do you hope to work as a mentor for him/her? What challenges do you anticipate in this relationship?

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* 12. The major project (change initiative) that the Aspiring Principal develops and implements during the residency is the opportunity for the Aspiring Principal to experience the complexities of leadership and leading change. Aspiring Principals need genuine work and access in order to demonstrate and achieve mastery of the program’s Distinguished Principal Qualities and state standards. This achievement is necessary for Aspiring Principals to receive certification. Due to this, the project is a vitally important part of this program.
~How will you as the Mentor Principal provide access, time, and the guidance needed for the Aspiring Principal to do this work?
(“Access” in this program means: guaranteed weekly reflection meetings with you, a group to work with on the project, a clear project focus, clear connection of the project goals to major school initiatives, and authentic authority in their leadership role to lead the change effort – supported by you and recognized by the faculty.)

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* 13. Please initial and date the following statement:

I understand that if I am selected to participate as a Mentor Principal in the Principal Residency Network, I will support the work of my principal intern until he/she has mastered the requisite program competencies. I agree to mentor the Aspiring Principal through daily conversation about our work, weekly meetings focused on scholarship and practice, and active participation in network activities including mentor work sessions, leadership presentations for my Aspiring Principal, and institutes. I agree to support the work of other Aspiring Principals through being available for occasional shadowing and school-related conversations and attending leadership presentations of other Aspiring Principals. I agree to provide as close to 50% release time for the Aspiring Principal as possible to focus his/her efforts on the projects and activities associated with the residency.

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