APPLICATION 2012–13 ACE Fellows Program Application Application Deadline is November 1, 2011 The Fellows Programs seeks to develop the leadership ability of individuals from all function areas and institutional sectors who have the capacity to rise to senior leadership, including cabinet level positions and the presidency, in colleges, universities, and higher education organizations, and who, through their future leadership roles, will shape the effectiveness, innovation, and direction of higher education. The complete application packet serves several purposes in the Fellows Program process. Applicants should be mindful of the many ways in which the application represents them to various assessors and for differing purposes. 1. Initially, this packet serves as the basis for selection of finalists who are then invited to ACE in Washington, DC, for interviews. 2. Interviewers prepare to meet the finalists through review of the application packets. 3. Final decisions about which finalists to invite to Fellowship are made through review of each candidate’s application packet. 4. The application packet serves to introduce the Fellow to prospective mentors as part of the process for securing a placement site. A complete application includes: 1. Application Form, submitted electronically to firstname.lastname@example.org. No paper copies will be accepted. 2. Transcript of highest terminal degree – preferably an electronic transcript sent to email@example.com. Hard copies should be mailed to ACE Fellows Program, One Dupont Circle NW, Suite 800, Washington, DC 20036. 3. Nomination/Sponsorship of Candidate Form 4. Confidential Evaluation Form, (3) per candidate. (Note: The Nominator/Sponsor may NOT also submit a confidential evaluation form.) CANDIDATE INFORMATION First Name: Middle Initial: Last Name: Current Title (Please provide (all) current title(s) as designated by your institution; including any professorial/academic title in full.): Institution: Office Address: City: State: Zip Code: Office Phone: [ ] - Office Fax: [ ] - Email Address: @ . Home Address: City: State: Zip Code: Home Phone: [ ] - Cell Phone: [ ] - Date of Academic Tenure (if applicable): Current Academic Rank (if applicable): NOMINATOR/SPONSOR INFORMATION Name: Title: Institution: Email: Note: The Nominator/Sponsor must be either the president/chancellor/CEO of your institution or organization, OR the cabinet level senior officer relating to your function area. The Nominator/Sponsor agrees to pay the candidate’s salary and benefits for the duration of the Fellowship, regardless of placement option; any applicable program fee and professional development fee relating to the placement option; and other costs associated with launching the Fellowship experience not included in the program fee. The Nominator also agrees to serve as a Sponsor to the Fellow throughout the Fellowship experience. If the Nominator/Sponsor is not the organization/institution president/chancellor/CEO, a signature from that person is required in addition to that of the Nominator/Sponsor to indicate institutional endorsement of the nomination. PRELIMINARY PLACEMENT PREFERENCE Please check one. We seek your preference at this time; if selected as a Fellow, you will have an opportunity to revise your selection. You should discuss this provisional placement preference with your Nominator/Sponsor before finalizing this application so that you and your Nominator/Sponsor are indicating the same initial placement preference. Academic Year (9-11 months, typically mid-August through mid-June, spent in learning through a placement at another institution. The Nominator/Sponsor is responsible for overall guidance of the learning experience with a Mentor at the host institution guiding learning during the placement period.) Semester ― my preference is: Fall Semester Spring Semester (A minimum of 12 weeks spent in learning through the guidance of a Mentor during placement at another institution. The Nominator/Sponsor is responsible for overall guidance of the learning experience and serves in the Mentor role when the Fellow is at the home institution in the non-placement semester.) Flexible Schedule of Periodic Visits (Combination of home + host institution placement with a minimum of 12 weeks at the host campus with remainder of time at the home institution. The Nominator/Sponsor is responsible for overall guidance of the learning experience and serves in the Mentor role when the Fellow is at the home institution between periodic placement visits. During the periodic visits, learning is guided by the Mentor at the host institution. The schedule of period visits is determined through consultation with the Nominator/Sponsor, host institution Mentor, and Fellows Program Director.) DEMOGRAPHIC INFORMATION GENDER: Male Female RACE/ETHNICITY: African American (non-Hispanic) Caucasian (non-Hispanic) American Indian Hispanic/Latino/Chicano Asian/Pacific Island American Multiracial Other, please specify: SERVICE: Member of the military Yes No Ordained clergy Yes No AFFILIATION OF Colleges and universities Public Private For Profit INSTITUTION: For other organizations: Association Foundation Other, please specify IS YOUR A historically black college or university (HBCU)? Yes No INSTITUTION: A Hispanic-serving institution (HSI)? Yes No A member of the American Indian Higher Education Consortium (AIHEC)? Yes No HOW DID YOU At what point in your career did you hear about the ACE Fellows Program? HEAR ABOUT THE ACE FELLOWS PROGRAM? Print advertising—please list publication(s): Please respond to all that apply, even if answers seem redundant. Electronic advertising —please list publication(s) and websites: Conference(s)—please list all conferences where you heard about the ACE Fellows Program: Nominator/Sponsor – please list name and e-mail address: Former Fellow(s)—please list name(s) and e-mail address(es) (if available): Supervisor(s) – please list name(s) and e-mail address(es) (if available): Other colleague(s)—please list name(s) and e-mail address(es) (if available): Social Networking Site: Facebook Twitter PROFESSIONAL HISTORY FORM The Professional History showcases your career history, administrative responsibilities, and leadership experiences. The Professional History is NOT an academic CV, although it may pull elements from such a document. Some tips for presenting yourself: Use standard CV formatting conventions with minimum narrative. The entire Professional History document should total no more than five (5) pages. List items in each section (e.g., appointments, publications) in reverse chronological order. To truncate long listings of activities and publications, provide a summary of overall activities, with relevant recent examples. To showcase the best professional presentation of yourself, please ensure accurate spelling and correct grammar. Remember that evaluators, presidents, and potential Mentors see correct spelling and grammar as part of professional presentation of self and may disregard an entire application, no matter how stellar the other considerations, if spelling and grammar are not accurate. You can type directly onto the form by using the “Tab” key to move from one text box to the next. Education: degrees, granting institutions, field, year; important non-degree education. Academic positions: Titles (please provide in full), institutions, years of service, date of tenure (where applicable), professional status. For your current position, note the range of responsibilities and leadership accomplishments. Administrative positions: Titles, institutions, years of service, date of tenure. For your current position, note the range of responsibilities and leadership accomplishments. Summary of scholarship, including publications, presentations, creative works, etc. Summary of teaching. Summary of professional contributions (aside from regular position responsibilities) to the institution, and beyond the institution: Summary of grant activity. Summary of international visibility and service. Summary of leadership development (programs attended, experiences created by/for you). Summary of honors received. Summary of other experiences of particular note. NAME: NAME Limit response to no more than 5 pages. Any text that exceeds 5 pages will be discarded. A It is an expectation that Fellows will contribute back to their home institution in the year after the Fellowship. What would you see yourself doing at your home institution in the year following the ACE Fellowship that would contribute to the capacity of your institution? What leadership contributions could you see yourself making to your institution as a follow up and as a contribution back to your institution after completion of the Fellowship year? Limit response to no more than 5 pages. Any text that exceeds 5 pages will be discarded. B Provide a brief sketch of what you see yourself doing within higher education in the next five to ten years. What types of formal and informal roles or positions do you see yourself fulfilling? What kinds of leadership contributions would you like to be making (a) to an institution and (b) to higher education as a whole? Limit response to no more than 5 pages. Any text that exceeds 5 pages will be discarded. C Summarize briefly a situation in which you provided leadership. Whether you were successful in reaching your leadership goal is less important to the question than your process toward the goal. Our interests in your answer have more to do with your reflections on and lessons from the leadership experience. Please provide some analysis: (a) Which of your own leadership efforts contributed to any degree of success? (b) In what ways could you have improved your leadership efforts? (c) What lessons did you derive from this leadership experience and how have you tapped those lessons for subsequent leadership efforts? Limit response to no more than 5 pages. Any text that exceeds 5 pages will be discarded. D In 25 words or less, what is your personal definition of leadership in higher education? E Why did you choose to apply to the ACE Fellows Program? Why did you choose it at this point in your career? What do you hope to learn from the experience as an ACE Fellow? Be specific. REFERENCES FOR CONFIDENTIAL EVALUATIONS List names, titles, addresses, phone numbers, and e-mail addresses for the three people completing the Confidential Evaluation. At least two references should be from present or former supervisors. Because your Nominator/Sponsor is already providing information to support your candidacy, you should not include your Nominator/Sponsor as one of your confidential evaluators. Name: 1. Name Title Institution Address City, State, Zip Code Email Address Phone [ ] - 2. Name Title Institution Address City, State, Zip Code Email Address Phone [ ] - 3. Name Title Institution Address City, State, Zip Code Email Address Phone [ ] - CANDIDATE SIGNATURE Type your name in the space provided. By checking this box, I agree that my typed name above serves as my signature. As such, I verify that, to the best of my knowledge, all of the information contained in this application is accurate. Also, I verify my understanding that the complete Fellowship experience includes the post-Fellowship year back at my home institution, and that I will fulfill this requirement of the Fellows Program. Note: This form must be submitted electronically through the applicant’s email address noted in the Candidate Information area.
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