1. Building inclusive leaders
Application form
programme

2. BUILDING INCLUSIVE LEADERS PROGRAMME 2019 – 2020
APPLICATION FORM
SUBMISSION DEADLINE: STRICTLY, 4pm Thursday 28th February 2019
In applying to the programme you must be able to attend all face-to-face elements of the programme. Should there be any difficulty with your availability, before submitting an application, please contact the Chief Executives’ Forum on to discuss the situation. Please note that this programme includes one mandatory overnight residential and a one day event in Dublin with optional overnight stay. All travel connected with this programme will be organised and paid for by the participants’ sponsoring organisations.
COMPLETING THE APPLICATION FORM:
Save as a PowerPoint file to your computer.
Click inside each answer box, type in your response (noting word limit) and save.
Either your application to or alternatively you can print off your completed form and post it (duly endorsed) to the address below.
NB: As your form must be approved and authorised by your Chief Executive, your submission MUST be cc’d to your chief executive’s address to confirm that the required endorsement is in place.
POSTAL RETURN ADDRESS:
CHIEF EXECUTIVES’ FORUM
Clare House
303 Airport Road West
BELFAST
BT3 9ED T E. W.

3. PART A: YOU AND YOUR JOB
Name:
Organisation:
Job Title:
Address for Correspondence:
Primary Purpose of Your Job:
Reporting Structure/Grade: (typically you should hold a second or third level post
reporting directly, that is, to the chief executive or to a director)
Date appointed:
Telephone:
Address:

4. Describe your career path, including key milestones, and your most significant
developmental experiences: (max 100 words)
2. Please demonstrate your direct involvement in:
Development strategic direction (max 50 words)
Leading change management (max 50 words)
Contributing to new ways of working (max 50 words)

5. INSERT YOUR NAME here Building inclusive leaders Programme
Tell us a little bit about yourself here :
(Overwrite your answer on this text)– whatever you are comfortable sharing.
My passion for leadership and for being of service:
What inclusive leadership means to me:
What I most want to achieve on this programme and how I hope it will impact my future career plans:
The strengths that you can expect to see from me are and why I‘m a good fit:
What I will be working on to improve myself over the next 12 months:
What I want feedback on during this programme:
Please stick to the space provided on this page to answer all questions.

6. Signed Date Print Name Signed Date Print Name
I understand that I am applying for a place on the CEF Building Inclusive
Leadership Programme and undertake to attend all modules
(Applicant)
I approve and authorise this application:
(Chief Executive)
Signed
Date
Print Name
Signed
Date
Print Name