Host School Application
***Special Note: Please be aware that this form cannot be saved as an in-progress project. It is recommended that you review the form prior to beginning the application to ensure you have all the information required. You should anticipate up to 30 minutes to complete the process.***

Please complete the following form to be considered as a host school. If you are requesting to host more than one candidate, please note that a mentor must be assigned to each and a letter of recommendation submitted for each. Only one application per building is required to be completed.

GENERAL INFORMATION
Please provide the primary contact's first and last name? *
Please provide the primary contact's email address. *
Please provide the primary contact's phone number. *
Please provide the school name. *
Please provide the full school address for the building that will host the candidate. *
Please select all grades served. *
Required
Please select all subject areas of need. *
Required
DATA COLLECTION
This information is collected solely for the purposes of reporting on program goals. The information is not considered in the decision to place a candidate in a host school.
What is the school's free and reduced lunch rate? *
Please provide the breakdown of race and ethnicity of your student population. *
What is the projection of student enrollment for the 2019-20 school year? *
What is the projection of openings for teaching positions for the 2019-20 school year? If greater than 10% of all positions, please provide context (i.e. turnover, growth, etc.) *
Please provide overall teacher retention rates for the past 3 years. *
What percent of staff was rated highly-effective for the 2017-18 school year? *
What percent of your highly-effective staff returned in 2018-19? *
To what do you attribute your retention trends across all teachers? *
ABOUT YOUR SCHOOL
Briefly describe the mission and vision of the school. *
Briefly describe how staff is engaged in bringing your school's mission and vision to life. *
Provide evidence of a positive school culture and climate. *
What does your school do to be an excellent option for students, parents and teachers? *
PROGRAM REQUIREMENTS
Please describe your definition of a highly-effective teacher. *
Please describe your existing model of coaching and mentorship, and any changes you anticipate in preparing to be a host school. *
Briefly describe your approach to educator evaluation and the alignment to professional development. *
Please describe the qualifications, experience and capacity of your chosen in-school candidate mentor(s). *
CANDIDATE MATCHING
How many candidates are you requesting to host for the 2019-20 school year? *
Please provide the amount of scholarship you will cover for each candidate placed in your school. (Total program cost is $7,500) *
Are you recommending a candidate(s) for the program? *
If yes, please submit a letter of recommendation illustrating the reason for the recommendation. If no, a matching process will be implemented to match candidates to host schools.
ASSURANCES
I understand that as a host school I am required to provide data to be used in the overall program evaluation. My data will not be shared separately or identified in any way. Data to be collected on a school-wide and teacher specific level includes but is not limited to: student growth data, student absenteeism, student behavior referrals. *
I understand that as a host school it is my responsibility to ensure adequate opportunity for observation and coaching for each candidate. Accommodations, such as two planning periods or similar, will be made to best support the candidate in the initial year of the program. *
I understand that as a host school it is my responsibility to be a partner with Professional Innovators in Teaching's staff and coaches in order to build a customized and responsive training and development plan for each candidate. *
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