MELD VII
Missouri Extension Leadership Development Program
Participant Application Form
MELD VII Program, 2016-17
Due Date: 4/29/16
1. Name
2. Work Address
City
State
ZIP
3. Title
Department or Region
4. Work Phone
Cell Phone
Home Phone
E-mail address
FAX
5. Previous Professional Experience (or attach resume or Curriculum Vitae):
Title
Dates
Employer Name & Address
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6. Community and/or Professional Activities (or attach resume):
List professional, civic, community, school, and/or other organizations that you have been actively
involved in over the past three years.
Organization
Address
Position
Dates
Please respond to the following essay questions (1 through 6) as a part of your application (may be
provided on a separate page).
MELD VII Application Short-Essay Questions
1. What are your professional goals for the next five years? (100 words or less)
2. Think about someone whom you consider to be a leader – what is it about that person that you may want
to emulate? (100 words or less)
3. Describe a job-related activity where you provided leadership. Describe what that leadership experience
has meant to you. (100 words or less)
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4. What is your vision for the future of University of Missouri Extension and/or the land-grant university?
(100 words or less)
5. The MELD program requires the development and implementation of a “change project”: an activity
designed to stimulate and guide constructive change. Note: You may change your idea during your
participation in the MELD class as a result of discussion and further thought and reflection. This
project should be within the parameters of your current job responsibilities and normal work load, but be
something that would be innovative for you or your current position. Alternatively, you may choose to
select an issue facing Missouri Extension’s future, as identified in the MU Extension Strategic Plan (see
goals below). Your change project should include personal reflection about the design and impact of this
activity. Please make a preliminary outline of a change project to indicate how you would approach this
aspect of the MELD learning experience. (100 words or less).
MU Extension Strategic Plan. The goals, as outlined below are aimed at fulfilling our
vision of University of Missouri Extension in a manner consistent with our mission and
our values:
1. Enhance MU Extension's access to and use of research to ensure relevant, reliable
and responsive educational strategies.
2. Maximize the impact on society by offering research-based programs focused on
high priority economic, environmental, and social outcomes and lead to MU
Extension being viewed as valued and trusted.
For more details on the components of the strategic plan, visit
http://extension.missouri.edu/about/strategic-plan.aspx
6. Why do you want to participate in a MELD class at this time? (100 words or less)
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*Submission of an application indicates that if selected into the MELD VII program, you agree to
participate fully in:
 the five, 4-day MELD VII seminars (Tuesday-Friday)
o Session One: September 27 – 30, 2016
o Session Two: November 29 – December 2, 2016
o Session Three: January 31 – February 3, 2017
o Session Four: April 25 – 28, 2017
o Session Five: September 26 – 29, 2017
 The small team learning activities
 Openness to all aspects of diversity
 Individual study
 A possible community service activity
 An innovation project, and
 Any other activities designed by the MELD planning team.
Applicant's Signature:
Date:
Supervisor’s Signature:
Date:
Please forward application to Supervisor for their electronic signature and approval before
application is forwarded via e-mail to Georgia Stuart-Simmons (StuartSimmonsG@missouri.edu)
by April 29, 2016. Exempt employees are eligible to apply. Two years of MU Extension experience
is preferred.
Questions regarding eligibility should be directed to Georgia Stuart-Simmons
(StuartSimmonsG@missouri.edu) (573) 884-3177
Submit completed application electronically on or before April 29, 2016 to: Georgia Stuart-Simmons
(StuartSimmonsG@missouri.edu)
MELD VII Training Team members
Vivian Anderson
Patrick Byers
Ina Linville
Craig Payne
Wayne Prewitt
Georgia Stuart-Simmons
MasonV@missouri.edu
ByersPL@missouri.edu
LinvilleI@missouri.edu
PayneCA@missouri.edu
PrewittW@missouri.edu
StuartSimmonsG@missouri.edu
University of Missouri Extension does not discriminate on the basis of race, color, national origin, sex, religion,
age, disability or status as a Vietnam-era veteran in employment or programs.
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