EOHHS MasSP Program Application Checklist
2014-2015
We are pleased to offer you the opportunity to participate in the EOHHS MasSP Program.
Employees who are interested in participating in this program must submit a complete application in order to be considered.
A complete application includes:
___ / a)Selection of a MasSP Track (Section I)___ / b)Completed Contact Information (Section II)
___ / c)Completed Essay Questions (Section III)
___ / d)Up-to-Date Resume (Section IV)
___ / e)Signed Applicant Statement of Commitment (Section V)
___ / f)All Required Signatures (Section VI)
The completed application packet must contain all of the components noted above and be submitted to:
EOHHS Center for Staff Development
600 Washington Street, 7th floor
Boston, MA 02111
Attn: MasSPApplication Review Committee
Applications may be:
- Scanned and emailed to (preferred)
- Mailed to address above
- Hand-delivered to address above
- Faxed to 617-348-5464
Applicationsmust be received by the Center of Staff Development by close of business September 12, 2014 to be considered for the MasSP Class of 2014-2015. Incomplete or late applications may not be considered.
MasSP…Preparing for Tomorrow Today
MasSP is a collaborative effort administered by
EOHHS MasSP Program Application
2014-2015
SECTION I: Selection of a MasSP Track
Please indicate which MasSP Track you are applying for and the geographic location you prefer. Please note that location choices vary by track. You may only select from the locations listed under your selected track.Please select ONE track only.
☐Aspiring Supervisor Track
For employees who strive to move into a supervisory position and seek to learn about the duties of a supervisor and the skills necessary to be a successful supervisor.
☐Boston (downtown)
☐Cape Cod
☐Southeast Mass
☐Central Mass
☐Western Mass
☐Emerging Manager Track
For employees who are experienced supervisors and would like to extend their careers in state government and move into managerial positions.
☐Boston (downtown)
☐Central Mass
EOHHS MasSP Program Application
2014-2015
SECTION I: Selection of a MasSP Track (cont)
☐Regional, Office or Area Director Track
For employees who are currently overseeing a unit or a program and aspire to lead a region, an office, or an area in EOHHS.
☐Boston (downtown)
☐Northeast Mass
☐Central Mass
☐Clinical Supervisor Track
For employees currently in clinical positions who would like to develop or enhance clinical supervisory expertise to ensure positive outcomes for patients and/or clients.
☐Boston (Shattuck)
☐Cape Cod
☐Western Mass
☐Senior Leader Track
For employees currently in a mid or upper-level management position who would like to move into agency senior management.
☐Boston
Note: Final program locations will be determined by number of applicants and location preferences.
EOHHS MasSP Program Application
2014-2015
SECTION II: Contact Information
Name:
Employee ID#:
Job Title:
Agency:
Email Address:
Work Telephone: ______Fax:
Work Address Building Name:
Street Address: ______Floor #:
City: ______State: ______Zip:
Professional License(s) or Certification(s):
Are You a Veteran? (optional) Yes _____ No _____
Supervisor’s Name:
Supervisor’s Job Title:
Supervisor’s Email Address:
Supervisor’s Telephone:
Manager’s Name:
Manager’s Job Title:
Manager’s Email Address:
Manager’s Telephone:
For reasonable accommodation requests, please contact
Engie Mota at 617-348-8471 or
EOHHS MasSP Program Application
2014-2015
SECTION III: Essay Questions
This segment of the application is an opportunity for you to demonstrate your interest and willingness to successfully complete the MasSP Program. Please respond to the following in 2-4 sentences:
Describe your commitment to public service.
What is your next career goal?
How do you think the MasSP Track you selected will contribute to you achieving your next career goal?
EOHHS MasSP Program Application
2014-2015
SECTION IV: Up-To-Date Resume
Please attach a typed, up-to-date resume.
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SECTION V: Applicant Statement of Commitment
I understand that, if selected, I am taking one of a limited number of available seats in the MasSP Program. As a MasSP participant, in addition to attending all of the required classes, I will be required to identify, implement and present an innovative project with the guidance of a Project Sponsor.
☐I agree to fully participate in the MasSP Program to the best of my ability, attend all scheduled classes and complete all required assignments.
Applicant Signature:
Date: ______
EOHHS MasSP Program Application
2014-2015
SECTION VI: Required Signatures
By signing below, I agree that this applicanthas received a satisfactory rating or above on his/her most recent EPRS or ACES and that I will fully support his/her participation in the MasSP Program.
Supervisor’s Name (print):
Supervisor’s Signature:Date:
Manager’s Name (print):
Manager’s Signature:Date:
------
Agency Head Signature is required for Senior Leader Track applicants only.
Agency Head Name:
(or designee)
Agency Head Signature: Date:
(or designee)
EOHHS MasSP Program Application
2014-2015
Submission Instructions:
Please submit the complete Application Packet to:
EOHHS Center for Staff Development
600 Washington Street, 7th Floor
Boston, MA 02111
Attn: MasSP Application Review Committee
Applications may be:
- Scanned and emailed to (preferred)
- Mailed to address above
- Hand-delivered to address above
- Faxed to 617-348-5464
Applications must be received by the Center of Staff Development by close of business September 12, 2014 to be considered for the MasSP Class of 2014-2015. Incomplete or late applications may not be considered.
Acceptance Process:
All completed applications received by the deadline will be reviewed by the MasSP Application Review Committee. As part of our commitment to host a program that has a diverse pool of participants with representation from agencies across the Secretariat, the CSD will partner with the EOHHS Office of Diversity, Equal Opportunity and Civil Rights.
The EOHHS Center for Staff Development will inform you, your supervisor, and your manageronce your candidacy status for the EOHHS MasSP Program has been determined. This communication will occur by the end of September 2014.
Thank you for your interest in the EOHHS MasSP Program. If you have any questions regarding the program or the application process, please feel free to contact Bonnie Tavares at (617) 348-5030or email at
MasSP…Preparing for Tomorrow Today
MasSP is a collaborative effort administered by
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