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Emerging Leaders Program Application

 3 years ago
source link: https://healthleadershipacademy.ca/education/emerging-leaders/emerging-health-leaders-application/
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Emerging Leaders Program Application

Thank you for your interest in the Health Leadership Academy’s Emerging Leaders Program. Any questions about the program or application process can be directed to Laura Smith at [email protected].

Personal Information

How do you identify?
Undergraduate StudentGraduate StudentYoung ProfessionalMid-career ProfessionalOther

First Name
Last Name
Email Address
Alternate/Personal Email Address

Telephone Number

Academic Information [if applicable]

University
Program
Faculty
Year of Study
Specialization

Employment Information [if applicable]

Current Employment
Part TimeFull TimeUnemployed

Role
Industry
Years of Employment

Preferred 2021 Program

MayAugust

Written Responses

1) What are you hoping to gain from this program both personally and professionally?

2) Describe a challenge that you had to overcome. What did you do and what did you learn?

Have you taken a program with the Health Leadership Academy before?

YesNo
If yes, which one and in what year:

How Did You Hear About Us?

Select all that apply. Hold down the CTRL key to select more than one option.
If "Other" please provide:
If faculty member or professor, please provide their name:
If another referrer (ie. alumni, colleague), please provide their name:

References

Please provide references that can speak to your leadership capability and success either personally or professionally.

Reference 1

Name
Title
Organization
Relationship
Telephone Number
Email Address

Reference 2

Name
Title
Organization
Relationship
Telephone Number
Email Address

Resume

Please attach your resume below (.docx or .pdf):

* Please attach only docx or pdf files.

Applicants will be asked to participate in a personal interview. Those moving to the interview stage will be contacted directly.


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