Indiana CTO Council CTO2B Application
We are excited to partner with the Indiana Department of Education to provide leadership development opportunities for Hoosier K12 leaders at the crossroads of technology and learning. Our desire is to increase professional knowledge, promote collaboration, and offer mentoring and leadership options to the k12 technology leaders of our state. This group may include Technology Directors and Coordinators, eLearning Specialists and Curriculum staff with a desire to become district leaders, as well as Assistant Superintendents and others who desire to mentor new Indiana IT leaders with thier knowledge and esperience. Please complete the form below to apply to be mentored through our CTO2B program. Forms for our CTO2B cadre 6 must be completed by August 17, 2018. Notification will be August 20th with a mandatory launch meeting meeting for all participants on Friday August 31st at the PLTW headquarters on the north side of Indy.

This form is for those who wish to be mentored.

First Name *
Your answer
Last Name *
Your answer
Phone number *
(xxx) xxx-xxxx
Your answer
Email *
Your answer
Address *
Your answer
City *
Your answer
Zip Code *
Your answer
School District or Organization Name *
Mentors mst be from an Indiana CoSN member organization
Your answer
Membership type *
Corporation ADM *
List "N/A" if not applicable
Your answer
Your Title *
Your answer
Length of CTO2B’s service to a corporation *
Length of CTO2B’s time in the K12 IT field *
Time you have spent in K12 IT (not including year teaching)
Certified Educational Technology Leader (CETL) *
Required
Program Commitment: I understand that working towards a professional license and developing my skills as a technology leader can be an extremely rewarding experience. I appreciate that the beneficial outcomes require a professional commitment to sharing openly, communicating effectively, and learning from each other. I agree to make a personal commitment of the time to attend training and have approval from my supervisor for participation in the program. *
Please also download and sign the signature form along with your Superintendent and submit with signatures.
1) Why are you interested in CETL certification and a vocation in IT leadership? *
(50-100 words)
Your answer
2) Briefly describe your IT and educational qualifications that have brought you to this stage of your career. *
(100-200 words)
Your answer
CTO2B AREAS OF GROWTH based on the Essential Skills of the K12 CTO *
Please indicate on a scale of 1-5 your areas of growth and strength as a CTO2B: Please reference the Essential Skills sheet when answering. http://www.cosn.org/sites/default/files/Framework_1212_2011_Public.pdf?sid=636
1 Growth Area 
2
3
4
5 Strength Area
Leadership and Vision
Strategic Planning
Ethics and Policy
Instructional Focus & PD
Team Building & Staffing
Stakholder Focus
IT Management
Communications Systems Management
Business Management
Data Management
3) Considering the Essential Skills of the K12 CTO, explain what you believe to be your areas of strength and areas of growth as you pursue this vocational path.
(100-200 words)
Your answer
4) What personal and professional characteristics might we consider in matching you with a mentor?
(100-200 words)
Your answer
5) What is your vision of being a CTO in the K12 environment?
(100-200 words)
Your answer
6) What do you believe to be critical in order to be a successful technology leader in the next decade?
(200-400 words)
Your answer
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