CONNECT/ Lead Advisory Leadership Program Application

* Please share your name.
0/250
* Please share the name of your institution.
0/250
* I have been selected by my institution and have secured funding to participate in this professional learning workshop series.
* Please provide your email address.
0/250
* Please provide your campus phone number.
0/250
* In the event that we need to contact you for an emergency, please provide your cell number.
0/250
* Please identify your current position.
0/500
* Please identify your department/division.
0/500
* How many years have you been employed in your current position?
0/250
* Please provide a brief description (1-2 sentences) of your current position.
0/500
* What are you hoping to gain from this experience?
0/500
* How do you hope participating in this program will enhance your contributions to your institution and accelerate your career growth?
0/500
* Have you participated in a leadership/management course in the past? If so, briefly describe the experience.
0/500
* Please provide the name and contact information for your supervisor. (We invite them to the final session to celebrate you and your accomplishments).
0/500
* Please provide the name and contact information for where the invoice should be sent on your campus.
0/500
* What are the biggest challenges you face in your current role?
0/500