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APPLICATION REQUIREMENTS FOR EXECUTIVE DIRECTOR of the North Dakota School Boards Association Please submit the following: Cover letter Completed application form supplied by NDSBA Résumé Official transcripts from institutions where a bachelor’s, master’s, and doctorate degree were earned; do not include transcripts for other coursework Two current letters of recommendation Deadline: May 1, 2017 All application materials should be sent to: Ms. Linnae Brew North Dakota School Boards Association P O Box 7128 Bismarck, ND 58507-7128 Phone: (701) 255-4127 Fax: (701)-258-7992 Email: [email protected] Application for the Position of Executive Director North Dakota School Boards Association Bismarck, North Dakota 58501 1. Name (Last) (First) (Middle) 2. Home Address (Street, City, State, Zip Code) Home Telephone Number (____) ________________ Office Telephone Number (____) ____________ Cell Phone Number (____) _____________________ Email Address 3. Present Position Employer ____________________________________________________________________________ Name and Title of Supervisor ____________________________________________________________ Supervisor’s Telephone (____) ________________ Email __________________________________ 4. Your current annual salary $___________________ 5. Your principal responsibilities __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ 6. Employment History: Please list in reverse chronological order all full-time positions held. Position Organization From/To No. of years Salary _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ 7. Professional Preparation: Please list both undergraduate and graduate degrees in chronological order. Institution Location Major/Minor Degree Date of Degree ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ 8. Honors and Awards: ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ 9. References: Please list names of three persons who are most familiar with your work and qualifications. Name Work Phone Cell Phone Relationship ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ 10. Respond in writing to the following questions (on a separate sheet). The NDSBA Board of Directors will evaluate the form, content, and style of your responses. 1. Why do you want to become the Executive Director of NDSBA? 2. How do you view the role of the Executive Director in relation to the state Board of Directors? 3. What are your thoughts about local control of public schools through elected school boards? 4. What strengths will you bring to the position of Executive Director? 5. If you were to develop a professional development plan for yourself, what items would be included? 11. Have you ever been reprimanded, disciplined, discharged, or asked to resign from a prior position? Yes No 12. Have you ever resigned from a prior position without being asked but due to an investigation or lawsuit related to your employment? Yes No 13. Have you ever been charged with, plead guilty or no contest to, or been convicted of a crime? Yes No 14. Have you ever been placed on probation for any crime or has a court ever deferred a proceeding of which you were the subject without entering a finding of guilty? Yes No If you checked “yes” to any of the above questions, please explain below, including the date of the incident, alleged offense, and, if applicable, charge, court action taken, and address of the court. 15. Have you been subject to a criminal history record check by the ND Educational Standards and Practices Board as a condition of licensure under NDCC § 15.1-13-14? (Select “no” if you were grandfathered in under this law.) Yes No I hereby grant authorization to the North Dakota School Boards Association to check my employment history including, without limitation, information pertaining to my employment from any of my present or former employers, supervisors, or coworkers; to check references; and to obtain investigation information, including criminal history records as authorized by NDCC § 12-60-24, as well as credit history and driving records. I will cooperate to the extent necessary to obtain the release of this information. I certify that I have made true, correct, and complete answers and statements on this application and acknowledge that they may be relied on in considering my application. Furthermore, I hereby waive my rights to confidentiality with regard to my work record or criminal record and consent to and authorize the release of information from current or former employers and/or law enforcement personnel upon inquiry under this application. North Dakota has broad “sunshine laws” and all records regarding the search are open to the public on request. Signature of Applicant Date This application must be completed and returned by MAY 1, 2017 to: Ms. Linnae Brew North Dakota School Boards Association P O Box 7128 Bismarck, ND 58507-7128 Fax: 701-258-7992 Email: [email protected]