Team Application for SEIR*TEC School Leadership in Technology Academy
Orlando, Florida
June 13 16, 2000

Mail or fax this application form and the individual forms for team members to: Vicki Dimock, Southwest Educational Development Laboratory, 211 East Seventh, Austin, TX 78701. Fax: 512/476-2286. Download application in Word format

Application forms must be received on or before April 10, 2000.

School or District: ____________________________

Names and Position Titles of Team Members (attach an individual form for each person listed here):

___________________________________________

___________________________________________

Describe your student population (Percentage Free and Reduced Lunch, Percentage Limited English Proficient, Ethnicity): __________________________________

__________________________________________

Please respond to each of the following:

1. What is your purpose for attending the Academy? Team attendance must clearly support the purpose you wish to accomplish.
2. Briefly describe the problem your team will work on during the School Leadership in Technology Academy Academy.
3. How does this problem relate to advancing your building/district school improvement/ professional development/ technology plans?
4. In response to the problem you have defined, what outcome(s) or product do you or your team intend to accomplish during the School Leadership in Technology Academy?
5. What topics would you like to see offered at the Academy? What kind of information would be most helpful toward the successful accomplishment of the outcome you seek?
6. How were team members selected? What strengths will each bring to the team process?

A signature of a school official who has authority to commit school/district resources to support team members travel, lodging, and meals while in attendance at the SEIR*TEC School Leadership in Technology Academy is required.

My signature below indicates my full understanding of the commitment I will be making if our application is accepted. I agree that team members will be in complete attendance and will participate fully in the SEIR*TEC School Leadership in Technology Academy, June 13 - 16, 2000.

___________________________________________

Signature                                        Title                    Date

For additional information regarding the SEIR*TEC School Team Academy, please contact Vicki Dimock at 1-800-476-6861, extension 219 or by e-mail at .