Chancellor’s Leadership Academy

Application

January 9 - May 2, 2009

Please complete this form to apply to the Chancellor’s Leadership Academy. This application must be submitted along with current abbreviated curriculum vitae or resume and a letter of support/recommendation from your direct supervisor. Application materials may also be sent via e-mail to Shirley Carraway (). One additional letter of reference may be submitted under separate cover. Applications and letters of reference should be sent in after November 1 and must be received by November 12, 2008. Admissions decisions will be made by December 15, 2008.

Name ______Date ______

Position/Title ______

How long have you been with ECU?______How long in your current position? ______

Please define your classification: ____ Staff

____ Staff/Administrator

____ Faculty (please specify rank)______

____ EPA non-teaching

____ EPA/Administrator

Gender: ____ Male _____ Female

How do you describe yourself? Please check one:

____ Asian American ____ Native American / Alaskan Native

____ Black / African American ____ White/Caucasian

____ Hispanic ____ Other: (please specify)______

Department/Unit ______

Campus address______Campus phone ______

Fax ______E-mail Address______

In a brief statement (no more than 150 words), please tell us about your education, work history, leadership experience, and any community service that prepares you especially well to benefit from the Leadership Academy. The statement should address the specific question of why you should be a candidate for the Academy.

Begin statement here:

Please indicate any special accommodation(s) and/or service(s) you require to participate in the Leadership Academy:

______

Name and title of person to whom you report:

______

Please respond to any three of the following items. As leaders, we play different roles based on experience and situations. Those factors also impact our personal leadership development process. Describe where you believe you are in your leadership journey. You may insert your answers after the questions below.

1.  Describe your interest in leadership and in participating in the Chancellor’s Leadership Academy.

2.  What books or other leadership material have you read recently or are you currently reading?

3.  Cite your personal and professional leadership strengths.

4.  What do you think are three (3) major issues facing ECU right now? Please provide a brief description of each.

References: Two letters of recommendation are suggested, one of which must be from your direct supervisor. Letters should provide a candid evaluation of your qualifications, skills, and potential for administrative leadership. Letters must be received under separate cover no earlier than November 1 and no later than November 12, 2008.

List the names and information for each reference.

Reference 1

Name ______

Title or Position ______

Department/Unit ______

Reference 2

Name ______

Title or Position ______

Department/Unit ______

Commitment

To graduate from the Chancellor’s Leadership Academy, you are expected to attend all sessions and agree to continue with the Academy in a mentoring/assistant role for at least one subsequent year. The dates for the sessions can be found on the program web site: http://author.ecu.edu/chancellor/leadership/

I understand the purposes of the Chancellor’s Leadership Academy. If I am selected, I will devote the time and resources necessary to complete the program. Even though emergencies arise, I understand and accept that I am expected to attend each of the eight sessions and complete the different assignments for the Academy. I understand the above commitment and agree to it by indicating my initials in the box below.

Initials: (By indicating your initials, you agree to the conditions above.)

For more information contact:
Dr. Shirley Carraway
737-2257

Office of Academic Affairs Special Programs
1914 W. Arlington Blvd., Greenville, NC 27834 / Dr. Virginia Hardy
744-3078