ACSA Leadership Institute 2022 Participant Application

Our application period for the Fall cohort 22-23 year is open through May 31, 2022.



  1. Possession of a valid teaching or services credential
  2. Minimum of five years of experience in your credentialed area
  3. Passage and/or proof of registration for CBEST examination


  • Resume
  • Copy of Transcripts (unofficial)
  • Copy of California Teaching Credential and/or Service Credential
  • Copy of CBEST verification or proof of registration for CBEST examination OR for Multiple Subject Teaching Credential, a passing score on all three subsets of the CSET
  • Personal Leadership Statement

Dear Candidates,

Please fill out the application below with all of the necessary information, be sure to double check for accuracy. Once you have submitted your application, you cannot change or edit the application.

For questions regarding the application form, please email credentialing(at)

For questions specific to the program, contact Dr. Michael Roe, mroe(at)

The application deadline is April 29, 2022 at 11:59pm.

After submission of your completed application, there will be an interview with the Leadership Institute. You will be notified by Dr. Michael Roe if you are selected for interview between April and May.

Click here for a recruitment/application timeline.

We look forward to welcoming our new cohort!

Good luck!

-ACSA Leadership Institute Team

Please review your application carefully for errors before hitting "submit," as you will not have another chance to preview your responses.

* Denotes CTC Requirement: Responsibilities of Commission-Approved Educator Preparation Programs All institutions (colleges, universities, school districts, county offices of education, charter schools and any other educational entity) approved to sponsor educator preparation programs in California that report racial and ethnic information to the Commission through the Accreditation Data System, or any other system in which such information is provided, must collect the following information for reporting:

· Sexual orientation information using the options: heterosexual/straight, gay/lesbian, bisexual, other, not sure, decline to state

· Gender identity using the options: male, female, nonbinary, decline to state

· Ethnicity using the options: American Indian or Alaska Native, Chinese, Japanese, Korean, Vietnamese, Asian Indian, Laotian, Cambodian, Filipino, Hmong, Other Asian, Black or African American, Hawaiian, Guamanian, Samoan,Tahitian, Other Pacific Islander, White, Other, or Decline to State.

While collection by educator preparation programs is mandatory, individual candidates must always be provided the option to decline to provide the requested information.

Preliminary Administrative Services Credential Application