Principal For A Day - Executive Sign Up Form

Thank you for your interest in PENCIL's Principal For A Day on Thursday May 15th, 2025!

We look forward to connecting you with students and administrators for a day that will open eyes, open minds, and open doors for all participants. Complete all required fields in this application form.

If you have any questions, please do not hesitate to reach out to Charles Parker at cparker@pencil.org.

Information

First Name	Last Name
E-mail Address	Phone Number
LinkedIn URL	Title
Company	Industry

Mailing Address

Street

Apt.

City

State

Zip Code

How many years of professional work experience do you have?

Please provide a short biography to share with potential school principals. Please include any connection to NYC public schools and if you have participated in Principal For A Day® in the past if applicable. Suggested length 200-300 words.

Assistant Information

Click here if you'd like your assistant to receive updates or communications on your behalf, please provide their contact details below.

First Name

Last Name

E-mail Address

Phone Number

Should we include them in all e-mails to you?

YesNo

Have you participated in a PENCIL program before? YesNoUnsure	If you have, please elaborate.
Did you go to a NYC public school? YesNoUnsure	Which school(s)?
Which times are you available on May 15th? Check all that apply Morning (8AM - 11AM)Afternoon (10AM - 1PM)Both	What grade level(s) are you interested in visiting for Principal For A Day? Check all that apply Elementary School (K-5) Middle School (6-8) High School (9-12)
Are you comfortable visiting a school with students with special needs? YesNo

Do you object to PENCIL promoting your experience thru digital and social media channels? YesNoUnsure	Are you interested in promoting your engagement through digital and social media channels? YesNoUnsure
Can we request to interview you afterwards about your experience? YesNoUnsure	Are you responsible for executing your organization’s employee engagement opportunities? YesNoUnsure
Are you responsible for hosting interns (high school and college level) in your organization? YesNoUnsure	Are you interested in learning more about our internship and school-based programs? YesNoUnsure

American Indian	Asian	Black / African American	Caribbean
Hispanic / Latino	Middle Eastern and Northern African	White	Pacific Islander
Other	Prefer not to say.

Principal For A Day - Executive Sign Up Form

Demographics