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LeadingSuccess™ Program Nomination Process

Program Overview

The LeadingSuccess™ Program is an introductory leadership skills development program targeted to faculty and staff who are motivated to increase their current leadership effectiveness and learn how to prepare for more complex or senior positions in the future.

Who Should Attend?

The program is open to faculty and staff within the Perelman School of Medicinegiven they meet the following criteria:

  • Currently supervises at least one direct report or is responsible for ongoing leadership of a project, team, or program
  • In current position for at least six months
  • If staff, has received an overall rating of “meets all expectations” or better during the most recent rating period.
  • Has not received any performance management or disciplinary actions (verbal or written warnings, performance plans) within the past year
  • Is committed personally - and has the support of their manager/faculty leader - to attend all scheduled program sessions
  • Consistently strong performer in current position.

In addition, the following characteristics are strongly desired for participants:

  • Demonstrated ability to receive and respond to developmental feedback
  • Strong desire to learn for the purpose of improving their performance

Nomination and Selection Process

We are accepting nominations for Cohort 16 of this program starting April 4, 2016. The process and timeline for selecting participants is as follows:

April 4, 2016 – May 2, 2016Nominations accepted. Nominations should be completed by immediate supervisor of proposed participant.

May 2, 2016 – May 13, 2016Nominations reviewed and final participant group selected

May 16, 2016Participant acceptance notification

If the person you would like to nominate meets the criteria above, fill out the following nomination form:

LeadingSuccess™ Nomination Form

To nominate someone for the LeadingSuccess™ Program, fill out the form below and email it (by saving it and then attaching it to an email) to by May 2, 2016. Nominations must be submitted by the current supervisor or faculty leader of the proposed participant.

NOTE: This form does not bookmark automatically. If you need to stop in the middle of filling it out, save it as you would any Word document and then reopen later and it will retain the data you have entered up until that point. Please keep a copy of your submitted nomination as we will not retain records after the nomination period.

Nominating Supervisor: the person completing this form to nominate someone for the program

Candidate: the person being nominated for participation in the program

Nominating Supervisor

Name:

Title:

Department:

Campus Address:Email:

Phone:

Are you the candidate’s immediate supervisor?Yes No

Candidate

Name:

Title:

Department:

Campus Address:Email:

Phone:

CandidateInformation

The candidate is Faculty Staff

If staff, indicate their employment affiliation:

University/ Perelman SOM UPHS Other

How many people does this person supervise?

Directly (conducts annual performance appraisal)

Indirectly (does not conduct performance appraisal, but directs or coordinates regular work activity)

Indicate the employment affiliation of these staff:

University/Perelman SOM UPHS Both

How long have they been in their current position?

305 Anatomy-ChemistryBuilding

215-573-0682

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0-6 months

7 months-1 year

2-5 years

6-10 years

Over 10 years

305 Anatomy-ChemistryBuilding

215-573-0682

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If staff, did they receive an overall rating of “meets all expectations” --or better--on their most recent performance evaluation? Yes No

Have they received any performance management or disciplinary actions (verbal or written warnings, performance plans) within the past year? Yes No

Briefly describe theirjob and responsibilities:

Why do you think this person would benefit from participating in the program?

Proposed Participant Information

How would other participants benefit from having this person in the program?

Is there any additional information you would like to include in support of your nomination?

305 Anatomy-ChemistryBuilding

215-573-0682