CEEL Academy Application

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Personal Contact Information

First Name*

Last Name*

Nickname

Home Address*

City*

State*

Zip Code*

Home Phone

Cell Phone

Home Email*

Work/School Information

Work Address*

City*

State*

Zip Code*

Work Phone*

Fax Number

School District*

School*

Current Position*

School Email*

Total years as an Educator*

Total years as a Principal*

Total years as Assistant Principal*

Number of years as principal/assistant principal at current school*

In the past, have you had coaching or mentoring?* Yes No

What do you hope to gain from your experience with the Character Education focused Emerging Leaders (CEEL) Academy?*

Does your school currently have an intentional character education initiative?*

What is (or will be) your role in character education in your school?*

What are the barriers (past, present and future) to implementing character education in your school?*

How will you arrange for your responsibilities to be covered when you are out of your building to attend the monthly meetings?*

Do you have any special needs for participation in the academy?*

Thank you, your application to the Center for Character and Citizenship has been successfully submitted.

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©2014, The Center for Character and Citizenship,
201 Ward E Barnes Library, University of Missouri-St. Louis, One University Boulevard, St. Louis, MO 63121-4400