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C E N T E R F O R E F F E C T I V E O R G A N I Z AT I O N S Human Capital and Effective Organizations Certificate application H U M A N C A P I TA L A N D E F F E C T I V E O R G A N I Z AT I O N S C E R T I F I C AT E To earn the Certificate in Human Capital and Effective Organizations, candidates must complete a specific set of 5 courses and participate in a community of practice. Because participants will be learning from each other as well as from USC faculty, it is important that participants have sufficient background to contribute to the program. The following questions will help us assess your fit with the Certificate program. The admissions committee will review your application and respond within 2 weeks. Please type or print clearly Dr. Ms. Mr. First Name Middle Initial Last Name Current Job Title Company Full Mailing Address (Please include street address and mail code) City State Zip Code Country (if other than U.S.) Telephone Fax E-mail Address Recommendations All applicants must be recommended to the program. Please list the names of up to 2 executives in your organization who know your skills and potential. Please inform them that we will be contacting them to discuss your candidacy. Name Title Business Relationship Telephone Email Name Title Business Relationship Telephone Email Job experience and educational background Please provide the following information in resume format. • A brief description of your current and previous jobs including: • your job responsibilities, reporting relationships, and the city/country where the work took place • any involvement or awareness of the strategic planning process at corporate, region, or business unit • Degrees, certificates and management or executive development experiences On a separate sheet of paper, please address the following YO U R M O T I VAT I O N • • • • What attracted you to the Certificate? What are your career goals? What do you want to get out of the Certificate? What issues are confronting your organization that you want to address? YOU R P RO P OSED F O CUS As you understand the Certificate program now, which courses do you think you will want to take? YOU R P OT EN T I A L CO N T RI BU T I O N A critical part of the certificate is a community of practice (CoP). We are interested in how you can contribute to this CoP. • • • • What do you bring to the community? What do you consider your areas of expertise? What areas would you like to explore within a CoP? In the past year, what books, movies, or experiences have most influenced your practice? Please sign and date your application below Applicant’s Signature Date Return your application to: HCEO Certificate Center for Effective Organizations Marshall School of Business University of Southern California Los Angeles, CA, 90089-0806 Phone: 213-740-9814 Fax: 213-740-4354 Questions about the Certificate? Email Susan Resnick-West at sresnick@marshall.usc.edu or call 213-740-9814 C E N T E R F O R E F F E C T I V E O R G A N I Z AT I O N S Marshall School of Business University of Southern California Los Angeles, CA 90089-0806 (213) 740-9814 Email: ceo@usc.edu http://ceo-marshall.usc.edu