APPLICATION FOR THE MTSU INSTRUCTIONAL
LEADERSHIP ACADEMY
Master in Administration and Supervision – Licensure
Educational Specialist - Licensure
Department
of Educational Leadership
Dr.
Jim Huffman, Chair
MTSU
BOX 91
Applicant’s Name ____________________________________________________
Last Name First Middle
Address____________________________________________________________________________
Street or Box
City State Zip
MTSU ID or Social Security Number
_______________________
School
System____________________________________________________
Current School Position __________________________ Position____________________
Number of years teaching
experience_____________ Grade level(s)_________________________
Applicant must
have a minimum of 3 years teaching experience in a public or state approved
private school.
Master’s Program ________ Ed.S. Program ______
Please supply the following support documents with this
application. Your application cannot be completed until we have all the
documentation. This application is for
the LICENSURE program.
1.
A copy of your current
teaching license or a copy of an MAT or GRE Score
2.
A copy of your most
recent performance evaluation and professional development plan.
3.
At least one letter of
recommendation from your principal or other supervisor that supports your
candidacy. The letter(s) should address
your teaching skills and work with students, leadership potential, or other
evidence supporting for your entry into the program.
4.
An interview form
completed by a designee of your school system.
5.
An interview completed
by a faculty member of the Leadership Program at MTSU (will be completed during
the first semester in FOED 6020)
On the back of this form or in an attachment, please
explain your interest in becoming an administrator and why you should be
considered for admission to the MTSU Leadership Program.
Applicant’s signature ______________________________ Date _________________________
.