Hillary Leadership Programme 2009 Application

Full Name:

Address:

Email:

Phone:

Mobile:

Job title:

Organisation:

Industry:

Nature of Organisation:

Could you include the contact details of two endorsers for your application who:

• You have been in contact with already to ensure they are comfortable being contacted by us
• Have had the opportunity to observe you in a leadership capacity
• At least one of them needs to be involved with your current leadership activities

We will be contacting these endorsers via email to request that they write a brief letter relating to the leadership they have seen from you and the leadership learning that they believe you would benefit from.

Endorser 1

Full Name:

Address:

Email:

Phone:

Mobile:

Association with you:

Endorser 2

Full Name:

Address:

Email:

Phone:

Mobile:

Association with you:

We would appreciate you including a brief Curriculum Vitae for yourself to accompany your responses to the questions below.

Scholarship

If you are applying for the Cawthron Science Leader Award, please tick this box and briefly outline below why you should be the recipient of this Award.

Please answer all of the questions below.

Question 1

Describe your current leadership responsibilities (formal and informal)

Question 2

What are your professional and personal objectives for the next 12-24 months?

Question 3

How do you want to develop your leadership to meet your objectives outlined in Question 2?

Question 4

Imagine it is in the future and you have completed the Hillary Leadership Programme. Describe the leader you are, the nature and impact of your relationships with others, and the difference you are making. Please describe in enough detail for us to get a strong sense of what you are thinking, feeling, doing and achieving as a leader (min 300 words).

If you have any questions about the Programme or this application process, please contact Excelerator's Programme Manager, Philippa Collins on 09 923 8807

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