Class of 2014 Leadership Program Application
UW Leadership Academy is designed to prepare individuals with potential for leadership roles at the
University of Wyoming by:
Developing participants’ leadership skills;
Promoting peer-to-peer relationships;
Creating Mentoring Opportunities;
Enabling participants to better contribute to the strength of the University;
Focusing on the University’s mission and vision;
Assisting the University in carrying out its mission through better equipped leadership.
Participants are selected by the UW Leadership Academy Selection Committee on the merits of the
information provided on this application. The Committee seeks representation from a cross-section
of the UW campus community, including those outside of Laramie. Information on this application is
used to add diversity and balance to the class, and is not made available outside of UW Leadership
Academy for any other purpose.
1. PERSONAL INFORMATION
Name _________________________________________________________________
Title___________________________________________________________________
Department _____________________________________________________________
Work Phone_____________________ Work E-mail _____________________________
Employee Class:
□ Professional
□ Academic
For how long have you worked at UW? __________________
2. APPOINTING AUTHORITY INFORMATION
Name __________________________________________________________________
Work Phone __________________ Work E-mail _______________________________
(Approval of your Appointing Authority is required before you can be considered for participation in the program*.)
3. PROGRAM COMMITMENT
UW Leadership Academy requires nine all-day sessions, as designated on the course schedule
every month, from September 2013, through August 2014, and participation is expected at all
sessions and the group project in the second year. If selected, can you devote the required
time to the program?
□ Yes
□ No
4. LEADERSHIP
Please answer the following questions; you are not limited to the space provided.
What is leadership? What is your greatest challenge in being a leader?
What do you consider your most Significant Contributions, Highest Career Achievements,
Awards/Recognitions, or Leadership roles related to your work?
What contributions/gifts/talents do you feel you would bring to the program?
If selected, I am fully prepared to be an active participant by attending all sessions, being fully
involved, and devoting the time and resources required to complete the UW Leadership Academy
program.
Signed: _________________________________________________
Date:
__________________________
*When you submit this application, an email will be sent to your Appointing Authority requesting approval of your
application. Appointing Authority approval is required to complete the application process. A letter of recommendation
from your Appointing Authority is encouraged.