*First Name:

Middle Initial

*Last Name:

Preferred Name:

Gender:

*Home Address (Street):

*City:

*State

*Zip Code:

*Home Phone:

Work Phone:

Cell Phone

*Preferred Email Address:

* Please Confirm your email addres:

Cluster in which you live:

Your Role in AACPS

*Cluster(s) in which you work:

*Current Position within AACPS:

*Current Supervisor:

*Current school/office:

*How many years or fraction of years
have you been in your current position?

*How many years or fraction of years
have you been with AACPS?

References

Each applicant must provide two professional references. Once you submit your application, you will be sent a link to the LDI Recommendation Form, which you must send to your chosen references. Please provide the first and last name of the first reference. This reference should be able to speak to your interest and passion for education and learning along with your work ethic and dedication to excellence.

* Reference 1 (first & last name)

*Ref 1 email address:

*Confirm email address :

*Ref 1 phone:

*Reference 2 (first & last name)

*Ref 2 email address

*Confirm email address:

*Ref 2 phone:

Personal Response

Personal Response 1:
Please explain, in 250 words or less, why you are interested in LDI and what you hope to acquire from this year-long experience.

Response 1:

Personal Response 2:
Please explain what you consider to be your greatest contribution to AACPS, its students, or your community thus far (250 words or less).

*Response 2:

Please indicate two attributes that show case your greatest strengths.

*First Attribute:

*Second Attribute:

Personal Response 3:
Please explain why you selected these attributes and how these attributes help you to bring success or forward movement to AACPS or the postitive work of the organization (150 words or less).

*Response 3:

Personal Response 4:
Please write about a time you failed at something and what you learned from this experience? (150 words or less).

*Response 4:

*Please upload a current copy of your resume/CV (3 page maximum; file must be saved as a PDF):

Confidential Demographic Information

Confidential Demographic Information (Optional):
The Leadership Development Institute seeks to reflect geographic, racial, cultural, and ethnic diversity in each class. Please indicate one or more category with which you identify:

Racial Catagory:

If you selected Other, please indicate
the racial category with which you identify here (optional):

Terms of Agreement

This program is offered at no cost to AACPS employees. Participants are not financially compensated for their participation in this program. Release time or a substitute teacher will be provided to participants who need this type of support for any LDI session held during the work day.

I have reviewed and fully understand the Leadership Development Institute program requirements and understand that completion of this application does not guarantee my selection for the program. If selected, I agree to the terms and conditions as stated and understand that I am expected to attend all sessions and participate in the full experiences and projects embedded within the program.