Mequon-Thiensville School District

City of Mequon and Village of Thiensville

5000 W. Mequon Road

Mequon, WI 53092

Phone (262) 238-8504 - Fax (262) 238-8520

Demond A. Means, Ed.D., Superintendent

Eric J. Dimmitt, Director of Curriculum, Instruction & Assessment

Hughes B. George, Director of Pupil Services

Gail M. Grieger, Director of Business Services

Dear Applicant:

Thank you for your interest in the Mequon-Thiensville School District. Your application process will be completed when the following materials are received:

1. Letter of application

2. Resume

3. Application form

4. Placement folder (references from a University Placement Office) or three

letters of recommendation

5. Transcript(s)

6. Copy of license

While not required, it will also be appreciated if you would complete the Minority Recruitment Survey.

Sincerely,

Dr. Demond A. Means

Superintendent


MEQUON-THIENSVILLE SCHOOL DISTRICT

5000 West Mequon Road Mequon, Wisconsin 53092

(262) 238-8500 www.mtsd.k12.wi.us

APPLICATION FOR PRINCIPALSHIP AT HOMESTEAD HIGH SCHOOL

DATE ______

POSITION APPLIED FOR ______

NAME ______

(Last) (First) (Middle)

HOME ADDRESS
Street
City State Zip

(Telephone) (Social Security Number)

HIGHER EDUCATION
Names of Colleges or Universities Attended / Location / Dates Attended
From To / Grade Point Avg. / Date of Graduation / Degree Earned
CERTIFICATION
Type of Certificate / Subjects, Grades, or Special Areas / Date of Expiration

The Board of Education does not discriminate on the basis of any characteristic protected under State or Federal law including, but not limited to, sex, race, religion, national origin, ancestry, creed, pregnancy, marital status, parental status, sexual orientation, or physical, mental, emotional, or learning disability in any of its student programs and activities. This policy prohibits any form of discrimination as defined by State or Federal law including, not limited to, Title II, Title VI and VII of the Civil Rights Act of 1964, Title IX of the Education Amendment Act of 1972, Section 504 of the Rehabilitation Act of 1973, and the Age Act.

ADMINISTRATIVE EXPERIENCE

Years
(Dates) / Name of School / Address / Position

Total professional experience in years

TEACHING EXPERIENCE

Years
(Dates) / Name of School / Address / Position
Grade, or Subjects Taught

REFERENCES

TEACHERS

Give names and addresses of three teachers with whom you have worked.

Full Name / Position / Complete Address and Email Address / Telephone Numbers

List and give the names and addresses of principals and superintendents under whose supervision you have worked during your career.

(Attach additional sheets if necessary)

PRINCIPALS

Full Name / Position / Complete Business Address and Email Address / Telephone Numbers

SUPERINTENDENTS

Full Name / Position / Complete Business Address and Email Address / Telephone Numbers

1.  In the space below, please state succinctly why you desire to serve as the principal of Homestead High School?

Please complete three of the following five essay questions:

2.  What was the single most important instructional achievement of your school or school system this past year in which you played a major role?

3.  Describe an instance when you proposed, implemented and measured the results of a transformational change in your organization.

4.  Please describe a time when you made a courageous decision to advocate for students in the face of criticism from your faculty or other adults.

5.  Please describe an instance when you demonstrated instructional leadership as an administrator.

6.  Please describe the most difficult personnel issue you have addressed as an administrator. What was the outcome of the issue?

Are you related to any person presently employed by the Mequon-Thiensville School District? If yes, what is the relationship?

Have you ever been convicted of a felony? If yes, explain

My signature below certifies that all statements made on this application are true and complete to the best of my knowledge. If employed by this school district, I understand that any misrepresentation of factual information contained herein may be cause for dismissal.

Signature

Date


MEQUON-THIENSVILLE SCHOOL DISTRICT

MINORITY RECRUITMENT SURVEY

THIS FORM IS OPTIONAL - IT IS NOT PART OF YOUR APPLICATION FOR EMPLOYMENT

Our school district is committed to seeking and hiring minority applicants for employment. We use this survey to gather information to help us meet this commitment. If you complete this survey it will be detached and kept in a file separate from your employment application. Your employment application will be considered on the basis of your job qualifications without reference to your age, sex, race, color, or national origin.

If you do not complete this survey it will not affect your application for employment. However, the information on this survey will be useful to us and we hope you will decide to help us by completing it.

Date ______

Position for which you are applying:

(If for teaching list subject or grade levels)

1st choice ______

2nd choice ______

3rd choice ______

Referral Source:

Friend Relative Placement Office or Agency

Advertisement in ______Other ______

Name ______Phone ( ) ______

Last First Middle

Address ______

Number Street City State Zip Code

Social Security Number ______

SURVEY INFORMATION

Check One: Male Female

Check one of the following:

Race/Ethnic Group: American Indian/Alaskan Native

Asian/Pacific Islander Black Hispanic White