NEOSHO JT. 3 SCHOOL DISTRICT
201 Center Street
Neosho, WI 53059
Phone: 920-625-3531

APPLICATION FOR THE POSITION OF DISTRICT ADMINISTRATOR

Applicants are to complete and submit this application form, letter of intent, resume, letters of recommendation, and copy of license. The letter of intent should include a personal statement as to your major professional accomplishments and your greatest professional disappointments. Applicant must hold the necessary and appropriate license as required by the Wisconsin Department of Public Instruction. All application material must be received by the Neosho School District no later than April 21, 2010. All inquiries and correspondence concerning this position should be directed to:

Ken Moe

c/o Neosho Jt. 3 School District
201 Center Street
Neosho, WI 53059
Phone: 920-625-3531

GENERAL INFORMATION

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Full NameHome Address/Mailing Address

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Home TelephoneBusiness Address

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Business TelephoneCurrent Contract Expires

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Date Available for EmploymentCurrent Salary

EDUCATIONAL BACKGROUND (in reverse chronology)

InstitutionMajor/MinorDegrees

EMPLOYMENT BACKGROUND (in reverse chronology)

Position in OrganizationStudents/All StaffReason for Leaving

PROFESSIONAL/COMMUNITY ACTIVITIES

OrganizationPosition/Offices Held

OTHER RELEVANT ACTIVITIES, HONORS, DISTINCTIONS, ETC.

REFERENCES – Please identify four persons who know about your professional qualifications and work, including your present position.

Home Work

Name Address Position Telephone Telephone

May we conduct a personal background check, including contact of your references, as well as present and previous employers? Yes No

Have you ever been convicted of a felony that substantially relates to this position? Yes No

Have you ever had a professional license or certificate suspended or revoked? Yes No

If yes, please explain.

Do you currently hold the appropriate administrator’s license? Yes No

CERTIFICATION STATEMENT

I certify that all answers to the questions on the application and all statements on all other information submitted as parts of the application process are true and complete to the best of my knowledge. I also release the Neosho Jt. 3School Districtfrom all liability for any damage that might be incurred in seeking or confirming eligibility and qualifications for the position.

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NameSignatureDate

QUESTIONS: Please prepare a response to the following questions. Your responses to all five questions are limited to three sheets of 8 ½ x 11 paper using a size 12 font.

  1. Why do you want to be the Principal/District Administrator of Neosho Jt. 3 School District?
  1. Describe two effective systems you have implemented to provide for the accountability performance of yourself and others.
  1. What changes or innovations have you personally lead in your school district?
  1. Would you describe yourself as a consummate professional? If yes, why?