Metropolitan Regional Educational Service Agency
1870 Teasley Drive, S.E.
Smyrna, Georgia 30080
Phone: (770) 432-2404 Fax: (770) 432-6105
iLEAD (Alternative Preparation for Educational Leadership)
educator candidate application
Section I – General Information for Recommended Applicant:
1. In order for us to consider the application for the Metro RESA Alternative Preparation for Educational Leadership (iLEAD) candidate recommended for the program in an educator position, we must have all information requested.
2. Metro RESA accepts applications from only school district superintendent or designee. Application must be signed by district superintendent or designee and school principal at the school level or other direct supervisor at the district level.
3. Print completed application.
4. READ and SIGN the application and secure all other required signatures on the signature page.
5. Scan application, including completed signature pages, and email the entire completed application to Metro RESA. Email completed application to .
6. Mail the original copy of the application with the completed signature page and application fee payment of $75 to the Metro RESA iLEAD Program at 1870 Teasley Drive, S.E., Smyrna, GA 30080.
Last Name: / First Name:Present Address
Street / City / State and Zip Code
Home Phone: / Cell Phone:
Email Address:
Section II – Certification Information: Please attach a copy of your current or most recent certificate.
Types of Certificate:Areas of Certification:
------To Be Completed by Applicant For Reporting Purposes Only ------
Date of Birth:(Month, Day, Year)
Gender: / Male / Female
Ethnicity: / Hispanic/Latino / Not Hispanic/Latino
Race: / American Indian or Alaskan Native / Asian / Black or African American / Native Hawaiian or Pacific Islander / White
Section III – Administration Recommendation: The school principal (for school level leaders) or the direct supervisor (for district level leaders) from the employing system must complete the following:
Metro RESA iLEAD Program
Recommendation Form
2016-2017
Section III: Recommending AdministratorAdministrator Name / Role
School System / School (if applicable)
I recommend the above named candidate for the Metro RESA iLEAD program, an alternative preparation program for Educational Leadership. I understand that in order to participate in the program, the candidate must meet the following criteria:
1. Receive from a LUA an offer of employment and recommendation for admission to the program and assurance that the candidate is available one-half day or more each day to work in a leadership position;
2. Hold, at a minimum, a bachelor’s degree from a regionally-accredited college or university and one or more of the following:
a. Teacher Leadership, Coaching, or Teacher Support and Coaching endorsement;
b. OR National Board Certification;
c. OR Master's degree in a GaPSC certification field;
3. Evidence of experiences in engaging colleagues in professional learning opportunities;
4. Exhibit professional leadership dispositions. As the recommending administrator, you must complete the online dispositions assessment developed and adopted by Metro RESA on the applicant prior to finalizing this application. You can access the link to the dispositions assessment developed and adopted by Metro RESA here: https://www.surveymonkey.com/r/2016iLeadDispositionAssessment
5. Evidence of effective teaching.
Section IV: School District/School Administrator Signature Verification:
I recommend the above named candidate for the Metro RESA iLEAD program--an alternative certification program for Educational Leadership. I understand that in order to participate in the program, the candidate must be employed for at least a half day each day and have the opportunity to complete 250 hours of job-embedded experiences including 30 hours of Shadowing and Field Experiences.Signature of School District Superintendent or Designee / Date
Printed Name of School District Superintendent or Designee
Signature of School Principal (for school level) or Direct Supervisor (for district level leaders) / Date
Printed Name of School Principal (for school level)
or Direct Supervisor (for district level leaders)
Section V: Assigned iLEAD School-based Mentor (Effective Leader)iLEAD Mentor Name: / Cert ID#:
Email: / Phone:
Signature:
Section VI– Applicant’s Authorization Statement: Describe the degree to which you use technology in your work and integrate it into student learning (if applicable); including technology programs/platforms with which you are familiar.
Knowledge and skills in technology programs/platforms:
Section VII: READ AND SIGN THE FOLLOWING STATEMENT AFTER COMPLETING THE APPLICATION.
I understand that the application, resume, and other data are the property of Metropolitan Regional Educational Service Agency (Metro RESA) and cannot be returned. I authorize full investigation of the information given in this application and consent to the representatives of Metro RESA contacting my references, previous employers, and schools attended. All information is considered confidential.
I understand the first cohort will be limited to 50 candidates. Cohort acceptance will be determined by critical need. Metro RESA will add additional cohorts as determined by system/school needs and MRESA capacity. Applicants meeting eligibility criteria but who are not accepted to participate in the first cohort will be maintained on a waiting list.
I understand successful completion of the iLEAD program requires meeting all iLEAD standards, attending all required sessions, completing all activities, submitting all required documents, and tendering all payments.
I understand I am responsible for the payment of fees. Arrangements for payment supported by other means is the responsibility of the applicant.
I understand official notification will be made via email on or before May 13, 2016.
APPLICANT’S SIGNATURE / DATEIt is the policy of Metro RESA not to discriminate on the basis of age, sex, race, color, religion, national origin or disability in its educational programs, activities, or employment practices.
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