USD 417 District Academic Council (DAC) Application
Please
complete this application form and submit it to the central office or a school
office by Friday, February 24. All
those who apply will be notified as to the status of their application by March
10.
Name: _____________________________________________________
Address: _____________________________________________________
_____________________________________________________
Daytime
Phone Number:
______________________
Email: ________________________
I
represent the following (please check all that apply):
(number on DAC)
_____K-5 teacher (PHES) (1)
_____6-8 teacher (CGMS) (1)
_____6-8 teacher (PHMS) (1)
_____9-12 teacher (circle:
Core, Elective) (2)
_____special education teacher (1)
_____certified personnel outside regular classroom (1)
_____community representative (circle: Alta Vista, Council Grove, Dunlap, Dwight, Wilsey)
(6)
high school counselor* (1)
building administrators (CG
ES/MS, PH ES/MS, HS)* (4)
curriculum director* (1)
superintendent* (1)
board member*
(1)
*not by application (total
DAC: 22)
Please
describe what qualities (characteristics and actions) you can bring to the
District Academic Council to help improve student learning in USD 417:
(Optional)
Other information that supports your application. Please list on the back of this page.