Education Leadership Institute
Fellowship Application
Application Overview
The Education Leadership Institute (ELI) Fellowship is an American Board of Physical Therapy Residency and Fellowship
(ABPTRFE) accredited leadership development fellowship program created in response to the needs of the physical
therapy education community. ELI is designed to develop current and future program administrators to facilitate the
needed changes in the academic environment for the 21st century. The comprehensive curriculum explores in depth
leadership development and is delivered through three required onsite sessions and ongoing distance learning. The
yearlong format allows participants to connect theory with practice through application and translation of knowledge to
their individual programs and institutions. For more detailed information, please click here: www.apta.org/eli
Major Content Areas Include:
 Personal Leadership and Management
 Higher Education, Healthcare Systems, and Society
 Institutional Leadership and Management
 Student Affairs
 Legal and Policy Issues
 Human Resource Management
 Resources and Financial Management
 Program Development and Outcomes
 Relationships, Influence, and Partnerships
Essential Features of ELI for Applicants to Consider
EXPECTATIONS AND TIME COMMITMENTS
The applicant should be prepared to:
 Complete a 2-hour virtual orientation webinar session in July that launches the ELI Fellowship program.
 Actively engage in on-line and self-directed learning in completing 9 learning modules with expert faculty
throughout the fellowship year.
 Actively engage in three (3) required two-day face-to-face didactic instruction sessions in a 12-month period
integrating content applied from each of the 9 modules. Required onsite sessions for 2016-2017 are as follows:
o Session 1: October 5-6, 2016 (location TBD)
o Session 2: 2 days in March 8-9, 2017 (location TBD)
o Session 3: 2 days in July 13-14, 2017 (location TBD)
 Develop a leadership project that responds to a need within his/her sponsoring institution.
 Develop a dynamic leadership development plan through ongoing reflection during his/her participation in ELI.
 Complete all course, participant, and program assessments and evaluations.
Education Leadership Institute
Fellowship Application
ELIGIBILITY CRITERIA
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The applicant should be a current or emerging leader or academic administrator.
Due to the urgent need to prepare current and future academic administrators, preference will be given to
applicants identified as novice (0 – 7 years) PT and PTA academic administrator leaders.
The applicant must be a current member of the APTA.
The applicant is CAPTE compliant if currently holding the position of PT or PTA program director.
The applicant must be licensed/registered/certified or licensure eligible in the United States and affiliated with a
U.S. academic institution.
Application Process
The applicant must:
Complete the Application Form
Complete a Letter of Intent
Provide a Curriculum Vitae with evidence of past leadership activities updated in the past 3 months.
Sign the Statement of Commitment
Submit at the time of the application, a nonrefundable application processing fee of $100.00.
Secure nomination from current Program Director, Dean, or other appropriate Administrator/Supervisor. To
access the Nomination Form for the Institution, click here.
Submit completed electronic application materials only accepted as individual Word documents to
libbyross@apta.org by January 15, 2016, 5:00 pm ET.
Application Form
APPLICANT INFORMATION (please Tab through to enter data)
Name of Applicant:
APTA Member ID Number:
Total Years in Full-Time Teaching Position:
Institution:
Current Academic Appointment:
Academic rank:
PT Program PTA Program
Years in this position:
Tenure Status (if applies):
Address:
City:
Work Phone: (
State:
)
-
ext.
Cell Phone: (
Zip:
)
E-Mail Work:
E-mail Home:
US License/Registration Number(s):
Licensure State(s):
-
Education Leadership Institute
Fellowship Application
APPLICANT DEMOGRAPHICS
We recognize that diverse learning communities are valuable to leadership development, networking and the
profession. While not required, we would appreciate your assistance in facilitating this desired outcome by responding
to the demographic questions below.
Race/Ethnicity:
American Indian or Alaska Native
Native Hawaiian or other Pacific Islander
Asian
White
Black or African American
Two or more races
Hispanic/Latino
Race and ethnicity unknown
Citizenship:
US Citizen
Foreign National
Age in years:
Gender:
Male
Female
LETTER OF INTENT
A strong application presents clear evidence of the applicant’s potential for leadership in physical therapy education. To
demonstrate this ability, the Letter of Intent should be no longer than two (2) pages (no smaller than 10-font) and must
include each of the following bulleted items:
1. Describe one of the following:
a. A defining moment in your leadership journey.
b. What has facilitated your growth as a leader?
c. Your greatest leadership challenge.
2. Your future leadership career goals.
3. Describe one or more areas in which you hope to grow or learn through your participation in ELI.
4. Contributions you may make to the ELI Fellowship cohort through your participation.
5. Describe a need your institution may be facing that might be addressed through a leadership project.
CURRICULUM VITAE
Provide your Curriculum Vitae and include evidence of past leadership activities that has been updated within 3 months
of this application.
Education Leadership Institute
Fellowship Application
APPLICANT STATEMENT OF COMMITMENT
The application process includes a statement of commitment for all required activities. Please review the statement
below and provide your signature to indicate your agreement.
As a member of the Education Leadership Institute, I commit to the year long obligation to the program, including:
1) virtual orientation webinar, 2) all on-site meetings as designated in this application (October, March, July) and
required learning activities and discussions, 3) completion of 9 online modules and accompanying readings, assignments,
discussion forums within an online community, virtual webinars, posttest assessment, and post module evaluations, 4)
the construction of a leadership development plan, 5) the development and presentation of a leadership project to
benefit my academic institution, and 6) ongoing program evaluations and assessments.
Signed:
Date (mm/dd/yy):
APPLICATION PROCESSING FEE
As a part of the application process to the ELI Fellowship, a nonrefundable application processing fee of $100.00 is
required for all applicants. To provide payment, please click here.
APPLICANT COVENANT
if accepted, all participants will be required to provide a signed covenant statement. Your signature will indicate your
pledge to maintain confidentiality of the information concerning participants, academic institutions, and programs
shared during ELI, and to uphold professional standards, including academic integrity and honesty.