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Extended Learning Superintendents Development Program
PERSONAL INFORMATION
First Name
Middle Name
Last Name
Informal Name (Name Tag)
Preferred Email Address
Cell Phone
Home Mailing Address
Home Mailing Address
Country
Street
City
Region
Postal Code
PROFESSIONAL INFORMATION
BOCES Regional District You Work In
BOCES Regional District You Work In
Albany-Schoharie-Schenectday-Saratoga BOCES
Champlain Valley BOCES (Clinton-Essex-Warren-Washington)
Franklin-Essex-Hamilton BOCES
Hamilton-Fulton-Montgomery BOCES
Questar III BOCES
Washington-Saratoga-Warren-Hamilton-Essex BOCES
Onondaga-Cortland-Madison BOCES
Cayuga-Onondaga BOCES
Oswego County BOCES
Tompkins-Seneca-Tioga BOCES
Putnam-Northern Westchester BOCES
Rockland County BOCES
Southern-Westchester BOCES
Madison-Oneida BOCES
Herkimer County BOCES
Oneida-Herkimer-Madison BOCES
Ulster County BOCES
Dutchess County BOCES
Orange-Ulster BOCES RIC
Sullivan County BOCES
Nassau County BOCES
Jefferson-Lewis BOCES
St. Lawrence-Lewis BOCES
New York State BOCES
Eastern Suffolk BOCES
Western Suffolk BOCES
Delaware-Chenango-Madison-Otsego BOCES
Broome-Tioga BOCES
Otsego-Northern Catskills BOCES
Greater Southern Tier BOCES
Monroe #1 BOCES
Monroe #2 Orleans BOCES
Wayne-Finger Lakes BOCES
Genesee Valley BOCES
Orleans-Niagara BOCES
Cattaraugus-Allegany BOCES
Erie #1 BOCES
Erie #2 Chautauqua-Cattaraugus BOCES
NA
School District Name
Work Phone
Work Address
Work Address
Country
Street
City
Region
Postal Code
Do you Have any dietary restrictions?
Do you Have any dietary restrictions?
Yes
No
Explain Dietary Restrictions:
REFERENCES
Name & Title of Professional Reference 1
Phone Number
Email
Address
Address
Country
City
Region
Postal Code
Name & Title of Professional Reference 2
Phone Number
Email
Address of Reference 2
Address of Reference 2
Country
Street
City
Region
Postal Code
Name & Title of Professional Reference 3
Phone Number
Email
Address
Address
Country
Street
City
Region
Postal Code
REQUIRED ATTACHMENTS
Please upload your current resume.
Please upload your letter of interest detailing why you are pursuing the SDP micro-credential.
Please upload your Superintendent Endorsement Form.
WITH THIS PROGRAM, DO YOU ALSO NEED SCHOOL DISTRICT LEADERSHIP (SDL/SDA) CERTIFICATION?
WITH THIS PROGRAM, DO YOU ALSO NEED SCHOOL DISTRICT LEADERSHIP (SDL/SDA) CERTIFICATION?
Yes
No
I ALREADY HAVE SDL/SDA CERTIFICATION
I ALREADY HAVE SDL/SDA CERTIFICATION
Yes
No
I DO NOT NEED SDL CERTIFICATION, BUT WOULD LIKE THIS PROGRAM TO CREDIT ME 9 COLLEGE CREDIT HOURS. I UNDERSTAND THAT I WILL HAVE AN ADDITIONAL CHARGE FOR THE 9 CREDIT HOURS.
I DO NOT NEED SDL CERTIFICATION, BUT WOULD LIKE THIS PROGRAM TO CREDIT ME 9 COLLEGE CREDIT HOURS. I UNDERSTAND THAT I WILL HAVE AN ADDITIONAL CHARGE FOR THE 9 CREDIT HOURS.
Yes
No
Program year
Program year
2024
2025
2026
2027
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