CHHS Leadership Development

Cohort Information

Please review the dates below; if the applicant you are sponsoring is accepted into the LDA you must be available to participate in the Sponsor Orientation, Sponsor Mid-Course Telecoaching, and Graduation.

Chief Deputy Director Concurrence

All Chief Deputy Directors will receive a list of all LDA applicants for information and possible prioritization. The CalHHS Agency will secure that concurrence prior to the review and selection of the cohort.

Sponsor Information

First Name: Last Name: Email: Phone Number: Additional Phone: Operational Title: Department: Division: Office/Unit: Reasonable accommodations:

Do you need reasonable accommodations to attend the sponsor portions of the CHHS Leadership Development Academy?

Yes - - Please Explain:
No
Have you been a sponsor in a previous cohort: Yes -- Which Cohort:
No
Previous Participation:

Have you participated in a previous cohort of the LDA?

Yes - - Which Cohort:
No
Reasons for sponsoring this individual:

State the reasons for sponsoring this individual. Explain why you believe the applicant is prepared to participate in the CHHS LDA and what traits the applicant currently demonstrates to exemplify a leader of the future:

Applicant Name

Applicant First Name: Applicant Last Name:

Privacy Policy:

The College of Continuing Education respects your right to privacy. Any information given to us when requesting course or program material will be used solely for the purpose of answering or responding to your request. We do not sell or otherwise distribute your personal information. We may, however, use it to provide you with advanced notices of our course offerings. If at any time you wish to be removed from our mailing lists, you may contact us and your request will be processed immediately.

Sponsor Endorsement

Cohort Information

Chief Deputy Director Concurrence

Sponsor Information

Applicant Name

Privacy Policy: