2012-13_Application

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					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 fellows@acenet.edu. No paper copies will be accepted.
2. Transcript of highest terminal degree – preferably an electronic transcript sent to fellows@acenet.edu. 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.