Coaching Enrollment Form

Fields with * are required.

Last Name: *

First Name: *

Email (NYC Department of Education email address): *

Office Phone Number: *

Extension:

School DBN # (example: 10X321): *

School Name: *

School Street Address: *

City: *

Zipcode: *

Grade Levels: *

Years of principal tenure (in total): *

Have you had a Leadership Academy coach in the past?: *

Yes

If you would like to request a particular coach, please enter his/her name here:

Please note that we will try to accommodate your request for a specific coach, but may not be able to in all cases.

Please check the coaching service(s) you would like to purchase.*

Full-Year Coaching
1:1 Coaching Packages

60 hours ($9,025.80 which includes food/space for two school team retreats).

48 hours ($7,220.64 which includes food/space for one school team retreat).

36 hours ($5,415.48).

Group Coaching Packages

60 hours ($9,025.80 split evenly among 4-6 participants).

48 hours ($7,2204.64 split evenly among 4-6 participants).

Additional Services

Add-on retreat(s) ($1,504.30 includes ten hours of coach time, food and space):

# of retreats

*Please note that retreats are available to be purchased only in addition to a 1:1, Group, or Project-Based Coaching package, and are not a standalone item.

Project-Based Coaching:

# of days ($1,053.01/day)

Anticipated Start Date:

(reservation valid for 30 days)

Additional Project-Based Coaching:

# of days ($1,053.01/day)

Anticipated Start Date:

(reservation valid for 30 days)

Thank you for enrolling in the Leadership Academy's Coaching Programs. We will contact you to confirm enrollment and provide purchasing instructions. If you have additional questions you can email us at coaching@schools.nyc.gov or call 718-752-7356.

We look forward to working with you and your school! Please submit below.