ECE Equity Leadership Academy Application Survey

The ECE Equity Leadership Academy is an executive-level program for San Francisco-based Center Directors, Administrators, and Family Child Care (FCC) Owner/Directors aimed at increasing knowledge, skills, and understanding of leadership grounded in racial equity, social justice, and values identification. We seek ECE leaders equipped with the knowledge, skills, and attitudes needed to build an equitable ECE system for all children. Participants will receive individualized coaching, leadership training, and incentives.

Participants will be required to attend monthly hour-long meetings.

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* 1. Full Name:

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* 2. Race/Ethnicity:

American Indian or Alaska Native

Asian

Black or African American

Latino or Hispanic

Middle Eastern or Northern African

Native Hawaiian or Other Pacific Islander

White or Caucasian

Multiple ethnicities

Prefer not to answer

Self-identify:

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* 3. Gender:

Male

Female

Non-binary

Prefer not to answer

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* 4. Preferred language:

English

Spanish

Cantonese

Mandarin

Other (please specify)

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* 5. Email address:

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* 6. Phone number:

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* 7. Preferred method of contact:

Text

Call

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* 8. Employer Name:

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* 9. Type of educator or affiliation:

FCC

Center

Other ECE professional (please specify)

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* 10. Job Title:

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* 11. City of Employment:

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* 12. Zip Code of Employment:

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* 13. Are you able to participate in monthly meetings (virtual and/or in-person)?

Yes, I can participate in both virtual and in-person

Yes, I can participate in virtual meetings only

Yes, I can participate in in-person meetings only

No, I am unable to participate in meetings

ECE Equity Leadership Academy Application

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* 1. Full Name:

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* 2. Race/Ethnicity:

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* 3. Gender:

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* 4. Preferred language:

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* 5. Email address:

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* 6. Phone number:

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* 7. Preferred method of contact:

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* 8. Employer Name:

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* 9. Type of educator or affiliation:

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* 10. Job Title:

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* 11. City of Employment:

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* 12. Zip Code of Employment:

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* 13. Are you able to participate in monthly meetings (virtual and/or in-person)?

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* 14. Have you participated in a training/workshop on Diversity, Equity, Inclusion, and Belonging (DEIB) in the past?

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* 15. Why do you want to participate in the ECE Equity Leadership Academy?

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* 16. Do you anticipate any challenges while participating in the program?