EIU EDL Interest Form -- Specialist Degree in Education (EDS)

Please complete this form if you are interesting in joining our Specialist Degree in Education (EDS) program, with an eventual Superintendent Endorsement.

THIS IS NOT an official admission form (visit www.eiu.edu/myeiu to directly and officially apply to the EIU Graduate School and our program).

* - Required fields

All EDS courses feature Virtual/Online delivery (via zoom/teams, +D2L)
When do you plan on starting your EDS courses? ... (SEM/YR; i.e. Spring/2027 or Summer/2027, etc.)
Name Name First Last
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Cell Phone Cell Phone - ### - ### ####
Home Email
Work Email
School & district currently employed
Position(s) held
Years of teaching experience
Locations of current or previous teaching experience
Years of administrative experience (if applicable)
Locations of current or previous administrative experience (if applicable)
Do you currently work in a public school district?

Do you currently work in a public school district? Yes No
Career goal in 5 years
Career goal in 10 years
Do you plan on becoming a public school superintendent?

Do you plan on becoming a public school superintendent? Yes No
If Yes,

If Yes, Within the next year Within the next 3 years Uncertain
Are there any special considerations we should be aware of in regard to your eventual admission to our program?