Application for Administrator Position (Principal)

Instructions:	Please type or print in ink. Complete all pages of the application. Attach an original copy or photostat of official transcripts and licenses documenting qualifications shown in Item II.

Date of Application:	Social Security #:

I. PERSONAL

Name
(Last), (First), (Middle)
Permanent Address
(Number & Street)	(City)	(State)	(Zip)
Mailing Address (if different than above)
Home Phone:	Office or Cell Phone:
Email

Employment:

Are you presently under contract?	Yes No	If yes, can you secure a release?	Yes No	When will you be available?

II. EDUCATION

Institutions Attended Including High School

Dates of Attendance	Name of Institution	Location (City/State)	Major Area of Concentration	Degree Received

Iowa Certificate

Folder #	Class	Expiration Date
Approvals	Endorsement

Other Professional Certificates/Licenses Issued to You

State/Folder #	Subject or Area of Responsibility

Professional Memberships:

III. PROFESSIONAL EXPERIENCE

Teaching Experience

Dates	School/Parish/City	Role	Responsibilities

Administrative Experience (Principal, Diocesan Office, DRE, etc.)

Dates	School/Parish/City	Role

Present Personal Professional Growth

List professional growth experiences during last 2 years (seminars, courses, professional readings, etc.)

Dates	Title

Teaching Experience (Any position held in fields other than education)

Dates	Position	Comments

Community Activities and Leisure Interests:

IV. REFERENCES (Give recent professional references. At least one must be an immediate supervisor.)

Name	Address	Phone	Role
1.
2.
3.

Regarding your philosophy of education: All those involved in a Catholic Education must earnestly desire to make the parish a community of faith which is, indeed, “living, conscious and active”. The faculty is the crucial group if the school is to function as a unit. By answering the questions below, you will demonstrate your ability and willingness to meet the school’s goals and objectives.

1.	Why are you interested in administering a Catholic school or Religious Education Program?

2.	What type of activities would you want to take place in the program to indicate that it is Catholic?

3.	How do you see yourself implementing social justice concerns in a Catholic school or Religious Education Program? (teacher/teacher, teacher/student, teacher/parents, teacher/administration relationships)?

4.	What do you consider as your greatest asset as a teacher/administrator?

5.	What workshops in interpersonal communication skills have you experienced? (e.g., Teacher Effectiveness Training, value clarification, human relations courses, moral teaching courses) How do you implement these skills)?

6.	What workshops/courses and/or experiences have you had that would assist you in teaching Catholic doctrine?

7.	What did you find most helpful about your college training in preparing you to be a good teacher or Administrator?

8.	What did you like best about the school in which you did your student teaching or internship?

I certify that answers given in this application are true and complete to the best of my knowledge. I authorize investigation into all statements I have made on this application as may be necessary for reaching an employment decision. In the event I am employed, I understand that any false or misleading information I knowingly provided in my application or interview(s) may result in discharge and/or legal action. I understand also that if employed, I am required to abide by all rules and regulations of the employer and any special agreements reached between the employer and me.

Signature of Applicant

RETURN TO:	Attn: Jr/Sr Principal Regina Catholic Education Center 2140 Rochester Avenue Iowa City, IA 52245	or Attn: Elementary Principal Regina Catholic Education Center 2120 Rochester Avenue Iowa City, IA 52245