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.