Official Seal of the California Department of Education

Form

Appointments Application

Executive Office

This application is used to apply for an appointment by the State Superintendent of Public Instruction.

All questions in this application are required unless otherwise specified.

For more information about the Appointments Application, please visit the Application for Appointments web page. If you have any questions, please email appointments@cde.ca.gov.

When you select Save Responses, a new screen will appear, and the Snap Survey will provide two options to save and return to the saved application. You can:

- Save the unique URL as a bookmark or add it to Favorites in your web browser. (We recommend that you save the link by educator if you are submitting more than one application.)

- Provide your email address and Snap Survey will email you the unique URL to return to the saved application.

Print Responses: Before you submit the recommendation online, print and review it for completion, grammar, and accuracy. Use the Print Responses button to print a copy of your responses for your records. When you select Print Responses, a new tab will open showing a printable version of the entire recommendation and your responses. To return to the recommendation, select the original tab in your web browser.

Appointments Sought

	Appointments Sought:
	Appointment #1:
	Appointment #2:
	Appointment #3:

Applicant Information

	Applicant Information:
	First Name:
	Middle Name: (Optional)
	Last Name:
	Address:
	City:
	State:
	Zip Code: (99999)
	County:
	Phone Number: (Best number to reach you; 999-999-9999)
	Fax: (Optional)
	Email Address:

Marital Status:

Married

Single