The Mary Ann Remick Leadership Program - Application Overview Webinar

Thursday, December 12, 2024 at 7:00 PM until 8:00 PMEastern Standard Time UTC -05:00

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Prospective Program (hidden)

Remick Leadership

Student Information

Prefix

Br.Dr.Mr.Mrs.Ms.Prof.Rev.Sr.

First Name

Preferred Name

Last Name

Birthdate

Birthdate

JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember1234567891011121314151617181920212223242526272829303120242023202220212020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924192319221921192019191918191719161915191419131912191119101909190819071906190519041903190219011900

Intended Entry Term

Summer 2025Summer 2026Summer 2027Summer 2028

Email Address

Mobile Phone Number

Would you like to receive text messages?

Would you like to receive text messages?

Yes

No

Employment Information

Total Years of Experience in Education

01234567891010+

(Arch)diocese

InternationalAnchorageJuneauBirminghamFairbanksMobileLittle RockPhoenixTucsonFresnoLos AngelesMontereyOaklandOrangeSacramentoSan BernardinoSan DiegoSan FranciscoSan JoseSanta RosaStocktonColorado SpringsDenverPuebloBridgeportHartfordNorwichWashingtonWilmingtonMiamiOrlandoPalm BeachPensacola-TallahasseeSaint AugustineSaint PetersburgVeniceAtlantaSavannahHonoluluDavenportDes MoinesDubuqueSioux CityBoise CityBellevilleChicagoJolietPeoriaRockfordSpringfieldEvansvilleFort Wayne-South BendGaryIndianapolisLafayette (IN)Dodge CityKansas CitySalinaWichitaCovingtonLexingtonLouisvilleOwensboroAlexandriaBaton RougeHouma-ThibodauxLafayette (LA)Lake CharlesNew OrleansShreveportBostonFall RiverSpringfieldWorcesterBaltimorePortland (ME)DetroitGaylordGrand RapidsKalamazooLansingMarquetteSaginawCrookstonDuluthNew UlmSaint CloudSaint Paul and MinneapolisWinonaJefferson CityKansas City-Saint JosephSaint LouisSpringfield-Cape GirardeauBiloxiJacksonGreat Falls-BillingsHelenaCharlotteRaleighBismarckFargoGrand IslandLincolnOmahaManchesterCamdenMetuchenNewarkPatersonTrentonGallupLas CrucesSanta FeLas VegasRenoAlbanyBrooklynBuffaloNew YorkOgdensburgRochesterRockville CentreSyracuseCincinnatiClevelandColumbusSteubenvilleToledoYoungstownOklahoma CityTulsaBakerPortland (OR)AllentownAltoona-JohnstownErieGreensburgHarrisburgPhiladelphiaPittsburghScrantonProvidenceCharlestonRapid CitySioux FallsKnoxvilleMemphisNashvilleAmarilloAustinBeaumontBrownsvilleCorpus ChristiDallasEl PasoFort WorthGalveston-HoustonLaredoLubbockSan AngeloSan AntonioTylerVictoriaSaint Thomas, American Virgin IslandsSalt Lake CityArlingtonRichmondBurlingtonSeattleSpokaneYakimaGreen BayLa CrosseMadisonMilwaukeeSuperiorWheeling-CharlestonCheyenne

Please specify what (arch)diocese:

Current School Where Employed

School Address

School Address

Country

Street

City

Region

Postal Code

Role

Role

K-12 School or District/Diocesan Leader

K-12 Teacher

K-12 School Staff (Counselor, Media Specialist, Campus Ministry)

What is your primary role as a leader?

AdmissionsAssociate/Assistant SuperintendentAthletic DirectorCampus MinistryDean/Assistant or Vice PrincipalDevelopmentPresidentPrincipalSuperintendentOther

What is your primary role on the school staff?

AdmissionsAthletic DirectorCampus MinistryCoachCounselorDevelopmentInstructional SpecialistLibrarian/Media SpecialistOther

Primary Role Teacher (HIDDEN)

Primary Role Teacher (HIDDEN)

Teacher

Please specify:

Current Position/Title

If you split time between teaching, please mark all that apply.

If you split time between teaching, please mark all that apply.

Admissions

Athletic Director

Campus Ministry

Coach

Counselor

Dean/Assistant or Vice Principal

Department Chair

Development

Instructional Specialist

Librarian/Media Specialist

Other

I do not split time.

If you have additional roles on the staff, please mark all that apply.

If you have additional roles on the staff, please mark all that apply.

Admissions

Athletic Director

Campus Ministry

Coach

Counselor

Development

Instructional Specialist

Librarian/Media Specialist

Other

Please specify:

Address Information

Mailing Address

Mailing Address

Country

Street

City

Region

Postal Code

Additional Comments

Any questions or topics you wish to be addressed?

Remick Role - Diocesan Leader (HIDDEN)

Remick Role - Diocesan Leader (HIDDEN)

Teacher

Teacher Leader

School Leader

(Arch)Diocesan Leader

Remick Role - School Leader (HIDDEN)

Remick Role - School Leader (HIDDEN)

Teacher

Teacher Leader

School Leader

(Arch)Diocesan Leader

Remick Role - Teacher (HIDDEN)

Remick Role - Teacher (HIDDEN)

Teacher

Teacher Leader

School Leader

(Arch)Diocesan Leader

Remick Role - Teacher Leader (HIDDEN)

Remick Role - Teacher Leader (HIDDEN)

Teacher

Teacher Leader

School Leader

(Arch)Diocesan Leader