Leadership Institute 2024

Leadership Institute Application

Name *

Job Title *

Institution/Organization

Name of college president or CEO? *

How many years have you been a member of NCMPR? *

How many years have you been in your current position at your institution? *

How many years of experience have you had in a supervisory role? *

How many staff do you currently supervise? *

Contact Information

Address *

Address 2

City *

State/Province *

Zip/Postal Code

Phone Number *

Email *

Please answer the following questions. Limited to 100 words max per response.

Briefly describe your role at the college. *

Reflect on what you believe to be exceptional leadership, both in and out of the profession. *

What are some of the main challenges in your work? What are the rewards? *

Briefly describe achievements or accomplishments that have been a direct result of your work at the college. *

Briefly describe your career goals. How do these relate to your current position?

Please attach a letter from the college president/CEO with their signature and endorsement of your application into the program. *

Maximum file size is 2MB

Will you need financial assistance?

If you answered "yes" to the above, describe how a scholarship will impact your ability to participate in Leadership Institute.

Check "yes" or "no" in the following question if you would like to apply for a DEI Scholarship. The scholarship is for members who are from underrepresented racial and ethnic backgrounds, gender identities, sexual orientations, and/or disabilities.

I do wish to apply for a DEI Scholarship. *

Please respond to the following: * Required Field

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