District Registration Gender* -- Select Option -- MaleFemalePrefer Not To Say Prefix* -- Select Option -- Mr.Mrs.MissMs.Dr.FatherSisterMx. First Name* Last Name* Address* City* State* Zip* Email* Date of Birth* Cell Phone* Home Phone* Ethnicity* -- Select Option -- Latino/HispanicAfrican AmericanNative AmericanAsian/Pacific IslanderCaucasian/WhiteOtherN/A Position* -- Select Option -- PrincipalAssistant/Vice PrincipalDirector of Special EducationAssistant Director of Special EducationDirector of CurriculumAssistant Director of CurriculumNon-Traditional Administrative TitleDirectorAssistant Director Date of Hire* Years in Education* Did the Applicant Complete NJEXCEL?* Yes No NJ Principal CE License Number* Out of State Principal Certification:* District has completed Provisional Registration Request in NJEdCert:* Yes No Resident Resume* Drop files here or Click to select file. Statement of Assurance* Drop files here or Click to select file. Copy of Board Approval* Drop files here or Click to select file. Current Job Description* Drop files here or Click to select file. School* School Type* -- Select Option -- PublicCharterPrivateParochialPrivate/ParochialPrivate/IndependentPrivate/Spec/Educ.Private/Service Prof.Other Grade Level* -- Select Option -- PrimaryElementaryMiddleSecondaryAdultK-12Other District Type* -- Select Option -- UrbanSuburbanRural County* -- Select Option -- AtlanticBergenBurlingtonCamdenCape MayCumberlandEssexGloucesterHudsonHunterdonMercerMiddlesexMonmouthMorrisOceanPassaicSalemSomersetSussexUnionWarrenN/A District* School Address* City* Zip Code* Phone* District Contact First Name* District Contact Last Name* District Contact Phone* District Contact Email* Entered By First Name* Entered By Last Name* Entered By Phone* Entered By Email* Payment of the $850 Administrative Fee will be submitted by:* -- Select Option -- DistrictResident Submit