Program Application

To participate in the Collaborative Change Leadership Program, candidates must meet the following prerequisites:

  • Senior and high potential experienced leaders in health care and education
  • Letter of Support from your organization to participate in the Program
  • An identified Capstone Initiative that engages an organization, system or community

Please fill in the information below:

Primary Contact Information

Team Members

Please provide the names and titles of your colleagues who plan to attend the program.

Supporting Documents

Please attach the documents described below:

A Current Curriculum Vitae for each team member (experience and education)

Motivation letter for each team member: a brief description of your leadership journey to date and how the Collaborative Change Leadership Program will help to enhance your leadership development:

*A one-page outline that describes the: underlying rationale and scope for change in the proposed capstone initiative that has been identified by the organization, system or community; the target population and/or community, and the organizational sponsor and partners that are willing to support this initiative:

*A letter of support from an organizational, system and/ or community sponsor indicating support for the capstone initiative and the time needed to participate in and complete the Collaborative Change Leadership Program: