The Leadership Institute Application Form
Scroll down to see the application form. Applications are due November 12th for the January 23-28, 2011 Institute. For additional information, please click on the “Details for Applicants and Participants” button to the left. Please complete and submit the form below by the due date. Applicants will be notified of their status within a few weeks of the closing date for applications.
Cancellations will be accepted only until five weeks before the start date of the Institute. Prior to that date, cancellations must be made in writing (e-mail is acceptable, please confirm that we have received) and funds will be returned, minus a $100 processing fee. There will be no refunds after that date and if an intended participant cancels after that date or is a no-show, the full registration fee will still be owed. We regret that we cannot offer refunds for late cancellations or no shows, however, if your agency would like to substitute another appropriate individual, this can be done with prior approval.
Once you submit this application, confirmation of our receipt of the application and a copy of your completed application will be sent to you electronically. However, we recommend that you copy and paste the questions requiring longer responses into a word processing document, draft and save your responses, then copy the text into this electronic application. This will assure you do not lose your work.
Questions requiring longer responses:
These questions are listed here so you can copy and paste to a word processing document to draft your responses. These questions are repeated within the application below. You should paste your responses in the spaces below to submit.
Your History: including, number of years in field, the various jobs you have held, the number of years you have been with your current organization; and your role in your current organization.
Your Organization: Please describe your organization’s mission, the types of services that are provided, and your organization’s philosophy and goals. If you work for only one division of your agency, provide general organization-wide information and more specific information about your division.
Your Future: Please describe where you see yourself professionally in five years.
The Field’s Future:Assume you are in charge of the changes that will take place for people with disabilities and their families over the next ten years. Don’t worry about what’s possible to accomplish within current funding limits or in this amount of time – you have a magic wand at your assist! What is your vision? If you could design the changes for people with disabilities and their families, what changes would you have made ten years from now?
Interest Statement: In a few paragraphs, please describe why you are interested in attending the Leadership Institute and how you feel it will benefit you and your organization.
Plans for Sharing Information and Learning: All participants are required to make a 2-3 hour presentation to a cross-section of representatives/stakeholders of their organizations (administrators, board members, staff at varying levels within the organization, people receiving supports, family members, funders, community members, etc.). You will work on the content and exercises for your presentation during the Institute. Describe preliminary plans for this presentation.
If you have any questions please contact Nancy Weiss at nweiss@udel.edu.
Part One: Contact Information