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MaTaRoT Leadership Coaching, National Applications, 2023-24
Name of person filling out form
Email of person filling out this form
Name of Lead Educator (if not the same as above)
(Person that will be working with the coach, referred to as Lead Educator following)
Title of Lead Educator (if not the same as above)
Email of Lead Educator (if not the same as above)
Cell of Lead Educator
Landline or Office Phone of Lead Educator
Supervisor of the Lead Educator
Number of Students
Number of Teachers
Number of other faculty/staff (aides, specialists)
Is your program part of a larger organization?
If yes, please indicate name of the "sponsoring program".
Education Director (if not listed above)
Email Education Director
Cell of Education Director
Email of Board President
Cell of Board President
VP of Education (if applicable)
Email of VP
Cell of VP
Education Committee Chair (if applicable)
Email of Education Committee Chair
Cell of Education Committee Chair
Name, Title, Email & Cell of anyone else involved supporting this work
Describe your leadership style? Describe three strengths you have as a leader?
Describe a leadership challenge you have faced this year. What made it difficult? What did you learn from the challenge?
Describe your top three priorities for strengthening your leadership practice and how these goals will lead to improvement in your school. (i.e., In what three areas would you like to grow? What would you like to change, and why? What would be different in your work by the end of the year?)
Identify and describe any obstacles or challenges you think will impede you addressing the priorities stated above.
Does your school have a stated vision or mission statement? If yes, please attach it here. If you do have a stated vision or mission statement, please share how your stated priorities align with that statement?
Please share your own self-reflection on the state of your school. What are the things you are most proud of? What are the areas that are most ripe for improvement?
Who else in your school shares your desire for working on the priorities listed above? What role will that person or people play in supporting you in this work?
What are you hoping to bring to the coaching relationship?
What skills, attributes and attitudes of the coach will make this relationship and the work most productive for you?
What would success look like for you at the end of the school year?
Please share any additional information about your work and your thoughts about what you and your institution will need to help sustain this work over the next few years? What else would you like us to know?