Golden Apple Award

Principal

Application Form
Nominee Information

Congratulations!

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You have been nominated for a Golden Apple Award. Please complete this 5-page form and make 5 complete copies, then return them to Livia Riley, Superintendent of Schools, by February23, 2018.

Your Name: Date:

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Address:

Parish:

School Information

Name and address of the school in which you are presently the principal:

School or Parish Pastor/Priest/ Chaplain who can attest to your practice and knowledge of faith and moral character:

Name of Nominator:

( ) Parent ( ) Teacher

Nominee’s Signature Date

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Nominee Information Form

Professional Experience

Dates

Start with most recent

/

School and Location

/ Courses Taught or Position
Education
Dates
Start with most recent / Institution and location / Degree

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Certification

State Teacher Certification – Please attach copies of Pennsylvania Instructional II Certificate, Administrative II Certificate and any other certificates earned.
Catechetical Certification – Please attach a copy of Catechetical Certificate(s)/or list below catechetical courses you have taken.

Dates

Start with most recent / Type /

Areas

Professional Development
(attach copy of PDE Act 48/45 hours)

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Service
To Church, School, and Community

Dates

Start with most recent

Essay

As the nominee, you need to submit this essay, in size 14 font with a maximum of 500 words.

Essay Topic:

The role of the principal in a Catholic school has many dimensions. What personal characteristics and leadership skills do you possess which enable you to be effective in a “Catholic” school setting? Why are you a principal in a Catholic school?

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Checklist

Each nominee should be certain to include the following for submission to the pastor/priest/chaplain. The pastor/priest/chaplain will then submit five (5) copies of the packet to

Mrs. Livia Riley, Superintendent of Schools.

Use the checklist below to be certain that your packet is complete.

  1. A completed application form – (Please make certain you have included all required documents.)
  2. Nominator Letter – Please include only one nominating letter. Additional letters will not be reviewed.
  3. Pastor/Priest/Chaplain Letter
  4. Nominee Essay

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