Fillable Arkansas Leadership Academy Master Principal Program Phase 1

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Arkansas Leadership Academy Master Principal Program Phase 1

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Copyright © 2019 Arkansas Leadership Academy
Arkansas Leadership Academy
Master Principal Program
Phase 1 Application
Institute sessions will be held at
the Winthrop Rockefeller Institute.
Session 1: July 23 – 26, 2019
Session 2: November 4 – 6, 2019
Session 3: February 25 – 27, 2020
Session 4: June 16 – 18, 2020
Submitting the application:
- Application is due by midnight June 2
nd
, 2019
- Mail, fax, or scan and submit signed and completed applications to:
Arkansas Leadership Academy
1 University of Arkansas
346 N. West Ave., Room 300
Phone (479) 575-8477
Fax (479) 575-8663
Email rdelsoto@uark.edu
- Should you have any questions, please email Richard Del Soto at rdelsoto@uark.edu
- NOTE: Applications are not considered complete until all components have been
signed and submitted
- Candidates will be notified of acceptance status by June 14th, 2019
Copyright © 2019 Arkansas Leadership Academy
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IN
DIVIDUAL INFORMATION
LAST NAME:
FIRST NAME: MIDDLE INITIAL:
HOME STREET ADDRESS:
HOME CITY: STATE: ZIP CODE:
HOME PHONE: CELL: HOME E-MAIL:
FEMALE: _ _ MALE: _
AFRICAN AMERICAN: _
HISPANIC: _
SCHOOL INFORMATION
ASIAN: _
NATIVE AMERICAN: _
CAUCASIAN: _
OTHER:(please specify)
SCHOOL DISTRICT:
SCHOOL NAME:
WORK ADDRESS - STREET: CITY: STATE:
ZIP CODE: COUNTY: PHONE:
WORK FAX: WORK E-MAIL:
EDUCATIONAL COOPERATIVE FOR YOUR DISTRICT:
TOTAL YEARS AS PRINCIPAL: (PLEASE RECORD YEARS OF EXPERIENCE AS A PRINCIPAL BELOW)
DATES SCHOOL / GRADE LEVEL DISTRICT
PLEASE CHECK THE ONE THAT MOST ACCURATELY DESCRIBES YOUR SCHOOL’S CURRENT
PERFORMANCE: LOW PERFORMING _ _ MIDDLE _ _ HIGH _ _
CURRENTLY PRINCIPAL OF THE FOLLOWING SCHOOL LEVEL:
ELEMENTARY: _ _ MIDDLE SCHOOL: _ _ OTHER (please specify):
JUNIOR HIGH: _ _ HIGH SCHOOL: _ GRADE LEVELS SERVED
Copyright © 2019 Arkansas Leadership Academy
Arkansas Leadership Academy
Master Principal Institute
Phase I
PLEASE ANSWER THE FOLLOWING QUESTIONS IN THE SPACE PROVIDED:
WHY IS IT IMPORTANT FOR YOU TO PARTICIPATE IN THE MASTER PRINCIPAL INSTITUTE?
WHEN YOU LOOK AT STUDENT TREND DATA IN YOUR SCHOOL OVER THE PAST THREE
YEARS, WHAT DO YOU FIND?
WHAT DO YOU THINK ARE THE TOP THREE FACTORS (REASONS) THAT CONTRIBUTED TO
THE RESULTS?
Copyright © 2019 Arkansas Leadership Academy
DISCUSS WHY YOU THINK SOME STUDENTS ARE NOT ACHIEVING AT YOUR SCHOOL.
BASED ON YOUR TREND DATA, WHAT ARE THREE KEY STRATEGIES (INTERVENTIONS)
YOU PLAN TO IMPLEMENT IN THE COMING SCHOOL YEAR?
Copyright © 2019 Arkansas Leadership Academy
COMMITMENT:
PRINCI
PAL
If selected to attend Phase I of the Master Principal Institute, I understand that I am making a commitment
for a one-year period. IN ORDER TO GRADUATE FROM PHASE I OF THE MASTER PRINCIPAL
INSTITUTE, I AGREE TO PARTICIPATE IN THE FOUR SCHEDULED SESSIONS THROUGHOUT THIS
INSTITUTE CYCLE. I UNDERSTAND THAT ATTENDANCE AT ALL FOUR SESSIONS IS MANDATORY.
Due to the volume of applications received, completing this application cannot guarantee placement in the program.
Notice of your application status will be emailed to you by June 14th, 2019
PRINCIPAL’S SIGNATURE ______________________________________________DATE______________
SUPERI
NTENDENT
IF IS SELECTED TO ATTEND THE ARKANSAS
MASTER PRINCIPAL INSTITUTE FOR Phase I:
♦ I COMMIT TO SUPPORT HIM/HER THROUGH THIS ENDEAVOR.
♦ I UNDERSTAND THAT HIS/HER ATTENDANCE AT ALL SESSIONS IS MANDATORY.
♦ I UNDERSTAND THAT IF MY PRINCIPAL MISSES ANY OR ALL OF A SESSION, THE SCHOOL
DISTRICT WILL RECEIVE AN INVOICE FOR INSTITUTE COSTS WHICH INCLUDE LODGING,
MEALS AND PARTICIPANT FEES.
I CERTIFY THAT THIS CANDIDATE IS A FULL-TIME BUILDING PRINCIPAL AND HAS A
TOTAL OF YEARS EXPERIENCE AS A PRINCIPAL (EXCLUDING ASSISTANT PRINCIPAL EXPERIENCE).
SUPERINTENDENT’S NAME AND EMAIL (please print) _ ______________________________________
SIGNATURE DATE
- Complete Application is due by midnight June 2
nd
, 2019
- Mail, fax, or scan and submit signed and completed applications to:
Arkansas Leadership Academy, 1 University of Arkansas, 346 N. West Ave., Room 300, Fayetteville, AR 72701
Phone (479) 575-8477
Fax (479) 575-8663
Email rdelsoto@uark.edu
- If sending signature page separately, please notate in email that all other components have been submitted
Additional information about the Master Principal Program is available on the Arkansas Leadership Academy
website at www.arkansasleadershipacademy.org
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Completed 18 August 2020

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