SECTION ONE

Please refer to the Program Brochurefor programdetails including eligibility and selection criteria.

Applicant Details
Family Name: Given Name: Title:
Position Title:
Faculty / Division:
School / Branch:
Employment Status: ☐ Full-time ☐ Part-time (please indicate FTE e.g. 0.5)
Level of Appointment: HEO
Year commenced at University of Adelaide:
Current University of Adelaide contract: ☐ Yes ☐ No
To be eligible for the program you need an employment contract that runs until at least December 2019. If your current contract expires before this date, please provide an additional letter of support from your Line Manager/Head of School indicating that your contract is expected to be renewed.
Number of staff reporting to you:
Or detail your role in leading/influencing others for business outcomes:
Please detail any previous leadership / management development training you have undertaken in the last 2 years
Application Questions
What are your development objectives, relevant to leadership,arising out of PDR or discussion with your manager?(up to 200 words)
What are the main benefits which will result from you taking part in this program?(benefits for you, your team, the university)(up to 200 words)
With reference to each of the four selection criteria, outline the reasons you are applying for a place on the 2018Professional Leaders Program? (up to 400 words)
Program Events
The Professional Leaders Program includes a leadership diagnostic, learning modules (workshops),experiential sandpit sessions and group coaching. There will also be a program launch and graduation events. Please refer to the Program Brochurefor more details.
Core events / Date
Launch Event / 24 April
11:30am – 4:30pm
Individual Diagnostic / Online completion
6 April - 20 April
Group Workshops: / Sandpit forums / Group coaching
Module 1: Leading Self / 3 May
9am – 5pm
Module 2: Leading Others / 4May
9am – 5pm / 15 May
11am – 12:30pm / 30 May
9:30am – 12:30pm
Module 3: Leading the Organisation – Systems Thinking / 6 June
9am – 5pm / 20 June
11am – 12:30pm / 27 June
9:30am – 12:30pm
Module 4: Leading the Organisation – Organisational Culture / 12 July
9am – 12:30pm / 26 July
11am – 12:30pm / 1 / 2 August
9:30am – 12:30pm
Module 5: Leading the Organisation – Service Effectiveness / 15 August
9am – 12:30pm / 28 August
11am – 12:30pm / 6 September
9:30am – 12:30pm
Module 6: Leading Change / 26 September
9am – 5pm / 10 October
11am – 12:30pm / 17 October
9:30am – 12:30pm
Graduation / 2 November
Time TBD
ApplicantSignature
I understand the commitment involved in taking part in this program and I am prepared and able to commit the time and effort required. I have discussed any support needed to participate with my manager.
Signature of Applicant: ______ Date: ______

SECTION TWO

Line Manager Support
Name of Line Manager:
Name of Applicant:
Does the applicanthave an ongoing University of Adelaide contract: ☐Yes ☐ No
If not, please confirm that you expect the nominee’s contract will be renewed:
Please outline why you believe this development opportunity would benefit the applicant (please write in the space below or provide a separate attachment):
I confirm that support will be provided to the applicantto enable them to participate fully in the Professional Leaders Program for 2018, and have discussed possible support avenues.
I will personally support the applicantin the following elements of the program:
  • Attend relevant program events where possible, i.e. Program Launch Event
  • Have regular discussion with my participant about their experience on the program
Signature: ______ Date: ______

SECTION THREE

Senior Leader* Endorsement
*Head of School, Branch Director or Faculty Executive Director depending on relevant structure.
I endorse this application for the Professional Leaders Program for 2018.
Print Name: ______
Signature: ______ Date: ______

Please submit completed Application Form to your Faculty/Division by no later thanTuesday13th March.