Branch Campus Leadership Institute Application

Application

50% of survey complete.

Beginning with the Inaugural 2018-2019 Class, the Branch Campus Leadership Institute brings the expertise of national administrators in off-campus locations to those wanting to enter, serve, and advance in the profession.

The basic profile of and criteria for selection are:

Current higher education remote location administrator, faculty, or staff member;
Sincere concern about the future of remote locations in higher education and a commitment to help shape the future;
Demonstrated commitment to higher education through past and present activities;
The potential for exercising leadership in the future; and
Willingness to commit time and energy to the organization.

Please complete your application by January 31 and include the $750 application fee (by payment or Purchase Order); refundable if the applicant is not accepted and not refundable if the applicant withdraws after acceptance. Applications will be reviewed and participants announced mid-February. Program fee balance of $1100 will be due no later than March 31.

We appreciate your interest in the Leadership Institute.
If you have any questions, contact the NABCA Executive Director at NABCA@NABCA.net

Thank you for your interest!

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1. Contact Information

Full Name

Institution

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

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2. Please list your educational and military (if applicable) degrees, achievements, significant awards or honors and dates.

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3. Please describe your role at your current institution (100 word limit).

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4. Please list employment for the past 15 years in reverse chronological order (including active military duty) including title/responsibility, and beginning and ending dates.

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5. In order of importance to you, list up to 5 community, civic, professional, business, or other organizations in which you are currently active or have been active in the past, and in which you have assumed a leadership role.

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6. Please describe an issue that you have impacted personally, which illustrates your actions as a leader at your institution. (250 word limit)

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7. What about the Leadership Institute motivated you to submit this application? (250 word limit)

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8. Describe your unique blend of personality, skills, and life experiences that you would contribute to your class. (250 word limit)

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9. Please list contact information for one person who is in a position to comment on what you would bring to the Leadership Institute. Provide their name, title, institution/company, telephone number and email address.