Leadership Programme for
Efficiency, Quality and Sustainability in
Healthcare through Innovation
Procurement
1-3 September, 2015
Madingley Hall, Cambridge, UK
To apply to join this programme, please provide us with the initial information requested below.
Please complete all sections and email the completed form to hayley.welsh@optimat.co.uk. A
member of our team will then be in touch.
Title:
First Name:
Last Name:
Job Position:
Organisation:
Address:
Country:
Email:
PA Email:
Telephone
Number:
Gender:
Male / Female
(please delete as appropriate)
Please indicate
your
competency in
the English
language:
Listening: 1
2
3
4
5
6
7
8
9
Writing:
1
2
3
4
5
6
7
8
9
Speaking: 1
2
3
4
5
6
7
8
9
Please indicate your level on the scale above, where:
4 = Basic user
6 = Independent user
9 = Proficient user
Please enter a
brief
professional
biography here:
Please outline
your main
reasons for
applying:
How did you
hear about the
programme?
Do you want to Yes / No
(please delete as appropriate)
apply for a
grant to
Please indicate the reason:
support for
travel and
accommodation
costs?
Declaration and Data Protection
DATA PROTECTION ACT (1998): I agree to Optimat Ltd (EcoQUIP Coordinator) and the
University of Cambridge Institute for Sustainability Leadership (CISL) processing personal
data contained in my application form whether provided by myself or by other individuals or
institutions, in support of my application, as part of the administration and registration
process. I accept that, should I be made an offer to attend the Leadership Programme, this
information will be retained during and following the event for administration and for the
provision of statistical returns.
I certify that the information given in this application is complete and accurate, and I
understand that if I have given false or misleading information the University of Cambridge
Institute for Sustainability Leadership will not admit me on to the programme and may take
legal action against me. I understand that if my application is unsuccessful, the papers
relating to it cannot be returned.
I agree to the above terms: YES (please circle to confirm)
I also agree to the Terms & Conditions (overleaf): YES (please circle to confirm)
Signature:
Information for Delegates
Programme Style
The programme has been designed to be highly participatory, with a mixture of formal
presentations and opportunities for dialogue, debate and analysis.
Plenary Presentations
Plenary presentations are generally limited to between 30 and 45 minutes, leaving ample
time for questions and general discussion.
Syndicate Sessions
Delegates gather regularly in small syndicate groups, each facilitated by a core faculty
member who will work with the group throughout the programme. These sessions allow
delegates to tackle key issues in greater depth and analyse themes in relation to their own
experience. They also prepare delegates for later sessions in the programme, ensuring that
they are in a position to make maximum use of the presentations and discussion that follow.
Advance Preparation
In advance of the programme, delegates are asked to read a short briefing document. The
briefing document will be sent to you at least three weeks prior to the programme start
date.
Programme Materials
Programme papers and presentations will be made available on a password-protected
alumni network website after the programme.
Dress Requirements
In order to encourage a relaxed and informal atmosphere, participants are welcome to wear
casual dress rather than formal business attire.
Photographs
We may take some photographs during the event and a group photograph will be taken on
the second day of the programme. If you wish to have the use of your photo restricted in
any way, please notify us.
Terms and Conditions
Acceptance on to a Programme
Acceptance on to a programme is by application and selection only. All applications are
reviewed by the Selection Committee, which seeks to achieve the optimum balance of
participants on each programme in terms of geographical spread, industry sector, gender
and area of expertise.
Delegate Participation
The CISL programme process involves group work which can be disrupted by the absence of
a delegate from any part of the event. Participants are therefore required to be in residence
on-site throughout the programme and be able to attend all sessions.
Membership of the Cambridge alumni network is also conditional upon full attendance.
Applying for a Visa for Entering or Studying in the United Kingdom
Please note that all programme participants are responsible for arranging their own visa for
entry into the UK, should one be required. CISL can provide an official invitation letter for
the programme in order to facilitate the obtaining of a visa specifically for the dates on
which the programme takes place. If you will require this, please contact us no less than
four weeks prior to the programme date.
Please note that any costs relating to visa applications will be at your own expense, as the
programme is not able to cover this expenditure.
Payment
Programme places will be guaranteed upon payment of the £220 programme fee, which
covers the cost of your accommodation and meals for the duration of the programme.
Details of how to make payment will be sent to you if your application is accepted.
The Cambridge Institute for Sustainability Leadership’s terms and conditions require for
payment to be made within 30 days of your application being accepted, or one week prior
to the programme start date; whichever is soonest.
Cancellation
Payments are non-refundable.
Programme places are not transferable to other participants; substitutions will be accepted
only at the discretion of the Selection Committee.
Accompanying Spouses/Wider Participation
Unfortunately, it is not possible to cater for accompanying spouses or other guests. The
programme is intensive and numbers of participants restricted, thus only delegates and
speakers may attend the sessions.