Applicant Criteria Women's Leadership Boot Camp is ideal for individual contributors and technical experts who need to influence others to achieve their goals. The program is designed for women who have been identified as high potential or emerging leaders expected to move into management ranks. Participants represent a variety of industries including manufacturing, nonprofit, legal and professional services. Application Deadline June 30, 2014 You are encouraged to apply early, as class size is limited. The application deadline is June 30, 2014. Application Checklist All application materials must be included at the time of submission. Application Current Resume Supervisor Form Scholarship Application, if applicable Payment Method Payment Information Tuition for Women s Leadership Boot Camp is $3,000. This includes leadership assessments, materials, program supplies, and meals at each session. If you are accepted into the program, a $500 non-refundable deposit is required at that time, but placement is not guaranteed until full payment is received. Full tuition is due by September 5, 2014. Please note that $500 is nonrefundable in the event that you withdraw your application or opt not to participate in the program. Payment can be made by credit card, by check made payable to YWCA Greater Cleveland, or your company/sponsor may be invoiced. Full payment must be received by September 5, 2014. Scholarship Information Preference is given to scholarship recipients who are employed by nonprofit organizations. Scholarships are based on level of need, with priority based on the order in which the request was received. To apply, please complete the scholarship application available online at www.ywcaofcleveland.org. Program Expectations Participants are encouraged to take full advantage of the program s many facets and engage in the learning process to their fullest capacity. Please give the following program expectations serious consideration. Commitment to the program provides everyone a rich and rewarding experience. If you feel you cannot meet the expectations of the program, please reconsider your application. Attend all sessions. More than two (2) unexcused absences could lead to termination Engage and participate in all sessions Show courteous behavior during sessions; no use of cell phones of any kind, laptops, tablets, or pagers, except during allotted break times Complete all assignments and assessments on time Meet with your Learning Partner and your Supervisor monthly between sessions to discuss program content and progress Learning Partners will be assigned during the September session YWCA Greater Cleveland www.ywcaofcleveland.org 1
2014-2015 Session Dates All modules listed below will be held on Fridays from 9:00 am - 5:00 pm, at Corporate College East (4400 Richmond Road, Warrensville Heights, Ohio). Schedule September 4, 2014: Orientation Day 1 (8-10:30 am) September 5, 2014: Orientation Day 2 (Module I) October 10, 2014: Module II November 7, 2014: Module III December 12, 2014: Module IV January 9, 2015: Module V February 6, 2015: Module VI March 5, 2015: Women s Leadership Conference (Optional) March 6, 2015: Module VII April 17, 2015: Module VIII May 8, 2015: Module IX YWCA Greater Cleveland www.ywcaofcleveland.org 2
Registration Information First and Last Name: Preferred First Name/Nickname: Title: Organization: Business Contact Information (preferred contact? yes) Address: City, State, Zip: Fax: Subscribe me to these enewsletters: Women s Leadership Racial Inclusion Home Contact Information (preferred contact? yes) Address: City, State, Zip: Mobile: Subscribe me to these enewsletters: Women s Leadership Racial Inclusion Emergency Contact Information Name: Relationship: Career Experience Total years of professional career experience: Total years of professional management experience: Years Years Are you currently in a management role? Yes No Level of Management First-Level Mid-Level Senior Level (if currently in a management role): Number of people you manage (if currently in a management role): Highest Educational Level Obtained: Executive People Salary Range: -,000-$80,000 -$100,000 YWCA Greater Cleveland www.ywcaofcleveland.org 3
Supplemental Questions (Required) What other leadership programs have you completed, if any? Please describe how your department contributes to the organization s bottom line. Describe why you are a good candidate for Women s Leadership Boot Camp. (Minimum of 200 words) What specifically do you hope to gain from participation in Women s Leadership Boot Camp? (Minimum of 200 words) Develop an action plan for your career using whatever format is most comfortable. Begin with your present position with a brief description of your current responsibilities. How do you see yourself growing as a leader? Project your title and potential responsibilities over the next 5-10 years. Note any concerns or barriers in your career plan. YWCA Greater Cleveland www.ywcaofcleveland.org 4
Demographics We use the following information to track the demographics of our participants. Your responses have no bearing on your acceptance into the program. Age: Under 30 30-34 35-39 40-44 45-49 50-54 55-59 60+ Race/Ethnicity: African-American Asian Bi-racial Caucasian/White Hawaiian/Pacific Islander Hispanic/Latino Multi-racial Native American Other: Highest Educational Level Obtained High School Diploma Bachelor Degree Master Degree Doctorate Professional Degree Other: How did you hear about this program: Brochure enewsletter Leadership Program Alumna YWCA Event Social Media Other: Social Networks: LinkedIn Twitter Facebook Google+ Twitter Handle, if applicable: Personal: Company: Photo and Statement Release I authorize YWCA Greater Cleveland to use audio, photograph, print, or video material of me for publicity or educational purposes in print or online communications. I understand I am not entitled to compensation or payment for their use. Initial Publications If you would like notice of your acceptance into Boot Camp to be sent to a professional or alumni magazine, please list the contact information. Name of publication: Contact name: Website: YWCA Greater Cleveland www.ywcaofcleveland.org 5
Supervisor Recommendation Form This form must be submitted with application. Applicant s Name: Supervisor s Name: Supervisor s Title: Address: City, Zip: Fax: What do you want the nominee to gain from the Women s Leadership Boot Camp experience? (Minimum of 100 words) Expectations of Supervisor/Sponsor: Approve participant s time out of the office for ALL sessions and activities. Meet monthly with the participant after each Boot Camp session to review learning. Consult with participant on work-related projects that enable participant to apply leadership skills to current position. Attend program kick-off on Thursday, September 4, 2014 from 8-10:30 am and the program closing on Friday, May 8, 2015 from 1:00 pm 3:15 pm. Supervisor understands that if the participant voluntarily withdraws or is dismissed from the program, no part of the program fee will be refunded. Supervisor/Sponsor Signature Date Your signature indicates your full agreement and acceptance of program criteria and expectations. YWCA Greater Cleveland www.ywcaofcleveland.org 6
Payment Method (please check only one) Checks should be made payable to the YWCA Greater Cleveland and mailed to: YWCA Greater Cleveland Attn: Women s Leadership Boot Camp 4019 Prospect Avenue Cleveland, Ohio 44103 My full tuition payment of $3,000 is enclosed (check). I understand that I will forfeit $500 of this payment in the event I choose not to participate in Women s Leadership Boot Camp. Initial My $500 non-refundable deposit is enclosed (check). I understand that this deposit is non-refundable in the event that I choose not to participate in Women s Leadership Boot Camp. Note: If you are accepted into the program, placement is not guaranteed until full payment is received. Full payment is due by September 5, 2014. Initial My deposit/tuition will need to be paid by credit card. Please call me at, for me to provide the YWCA with credit card information to process the tuition payment. Initial My tuition will be paid for by my company. Please invoice me and I will submit the invoice for payment. Initial My ability to participate in Women s Leadership Boot Camp is dependent on scholarship assistance and I have attached my scholarship application. Initial Optional: Register for the 10 th Annual Women s Leadership Conference on March 5, 2015. Please include the registration price of $199 with the preferred method of payment above. The Annual Women s Leadership Conference highlights nationally acclaimed speakers, features powerful breakout sessions, and provides opportunities for networking with hundreds of professional women in the Cleveland area. Commitment I understand that if I am accepted to Women s Leadership Boot Camp and voluntarily withdraw from the program or am dismissed for attendance or other reasons, no part of the tuition will be refunded. I have read and understand the program expectations and agree to meet these expectations to my best ability. Application Submission Application deadline is Monday, June 30, 2014. Please make sure all application materials are complete before submission. Incomplete applications will not be processed. Applicant s Signature (Typewritten accepted for electronic registrations) Date Application Submission: Contact: YWCA Greater Cleveland Amanda Cusick Kenney Attn: Women s Leadership Boot Camp Coordinator, Professional Development Programs 4019 Prospect Avenue 216-881-6878 x220 Cleveland, OH 44103 akenney@ywcaofcleveland.org Fax: 216-881-9922 YWCA Greater Cleveland www.ywcaofcleveland.org 7