LEADERSHIP BROOKDALE

A Professional Development Activity of Brookdale Community College

APPLICATION page 1 of 2

Leadership Brookdale provides professional development workshops for all members of Brookdale's community who are in a leadership position, aspire to be in a leadership position, and for those who would like to build on those skills that make for effective leaders.

Beginning in September, members meet one Friday a month for eight months from 12:30 - 4:00 p.m. Leaders from Brookdale and other organizations present workshops on various leadership and management topics at each meeting. A graduation ceremony is held in May. All members of the college may apply for admission. Each class consists of approximately 15 members. All applicants must notify their supervisor of their application.

In order for Leadership Brookdale to accomplish its goals, the full participation of each individual is needed. A commitment to 100% attendance will be asked of all members who participate To apply, complete and return this application to Tracy Smith, Leadership Brookdale Coordinator, Atec Bldg. For more information email or call 224-2754.

PERSONAL DATA (please print)

Name _______________________________________________________________________

Position/Title__________________________________________________________________

Department___________________________________________________________________

Location/Building (for interoffice mail)_______________________________________________

BCC Phone__________________________

How did you hear about Leadership Brookdale?______________________________________________

REFERENCE

Please list one Brookdale reference who has knowledge of your leadership potential.

Name ______________________________________________________Ext. ____________

QUESTIONNAIRE page 2 of 2

INTERNAL PROFESSIONAL ACTIVITIES AND COMMITTEE INVOLVEMENT

List any College professional activities or committee involvement in which you have participated. For each activity, indicate the nature of your participation, including any leadership position you have held.

EXTERNAL ORGANIZATION, BUSINESS AND PROFESSIONAL ACTIVITIES

List any civic, business or professional activities in which you have participated. For each activity, indicate the nature of your participation, including any leadership position you have held.

WHAT IS YOUR DEFINITION OF A LEADER? Use Examples if possible.

WHAT DO YOU CONSIDER YOUR GREATEST PROFESSIONAL ACHIEVEMENT?

Return the completed application to: Tracy Smith, Leadership Brookdale Coordinator, Atec Bldg.