Leadership for the Government Manager Application

Complete the Application form below and click the Submit button when finished. Upon acceptance to this program, the College of Continuing Education will send you a Registration Agreement which will need to be completed, signed and emailed to Matthew Van Donsel in order for your nomination to be valid.

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Applicant

Formal First Name:

this name will appear on formal documents, i.e., certificate

Formal Last Name:

this name will appear on formal documents, i.e., certificate

Preferred Name:

For nametags and class rosters

Working Title: Agency / Department / Organization: Division: Office/Unit: Civil Service Classification:

If applicable

Mailing Address: City: State: Zip: Telephone: Email: Referral:

How did you hear about the Leadership for the Government Manager Program?

Applicant Demographic Information

Alum:

Are you a Sacramento State University Alum?

Yes No

LGS Alum:

Are you a Leadership for the Government Supervisor Alum?

Yes No

Highest Level of Education:

Position

Chain of supervision:

How many people do you directly supervise? How many people do you indirectly supervise (total number of individuals that are within your chain of supervision)?

Current duties:

Description of current executive and/or enterprise level duties

Previous experience:

List of previous experience and dates

Applicant's Manager

First Name: Last Name: Working Title: Agency / Department / Organization: Division: Office/Unit: Civil Service Classification: Mailing Address: City: State: Zip: Telephone: Email:

Professional Reference 1

First Name: Last Name: Relationship: Mailing Address: City: State: Zip: Telephone: Email:

Professional Reference 2

First Name: Last Name: Relationship: Mailing Address: City: State: Zip: Telephone: Email:

Short Answer Questions

1. Organizational Benefit:

In 500 words or less, please answer the following question: How would you and your organization benefit by your participation in Leadership for the Government Manager?

2. Do you currently have a mentor:

Yes No

3. Was your mentor helpful:

If yes, in what ways has he or she been helpful to you?

4. Skill development:

What additional skills do you want to further develop?

Cohort Information

If this nominee is selected, we will make every effort to put them in the cohort indicated below, however, we are not able to guarantee a place in any cohort. Cohorts are selected to reflect a balance in many areas including IT/Programming, department, etc.

Select the preferred cohort:

Please review the dates below and select the preferred cohort.

Cohort 39 - $4,029.00 (Deadline: 11/10/23)

Course Delivery: In-person at Sac State

Day 1 - Strategic Management: Wednesday, January 10, 2024

Day 2 - Communication and Coaching: Thursday, January 11, 2024

Day 3 - Strategic Planning: Wednesday, February 7, 2024

Day 4 - Managing Operations: Thursday, February 8, 2024

Day 5 - Improving Business Processes: Wednesday, March 13, 2024

Day 6 - Managing Organizational Change: Thursday, March 14, 2024

Day 7 - Building High Performing Teams: Wednesday, April 10, 2024

Day 8 - Managing Conflict: Thursday, April 11, 2024

Day 9 - Presentations & Graduation: Thursday, May 16, 2024

Cohort 40 - $4,029.00 (Deadline: 11/10/23)

Course Delivery: In-person at Sac State

Day 1 - Strategic Management: Wednesday, January 17, 2024

Day 2 - Communication and Coaching: Thursday, January 18, 2024

Day 3 - Strategic Planning: Wednesday, February 14, 2024

Day 4 - Managing Operations: Thursday, February 15, 2024

Day 5 - Improving Business Processes: Wednesday, March 20, 2024

Day 6 - Managing Organizational Change: Thursday, March 21, 2024

Day 7 - Building High Performing Teams: Wednesday, April 17, 2024

Day 8 - Managing Conflict: Thursday, April 18, 2024

Day 9 - Presentations & Graduation: Thursday, May 23, 2024

By submitting this application, I understand that I am committing the time and effort for all eight courses of the program.

Terms of the application:

I further understand that, upon acceptance, the application becomes valid when the Registration Agreement is received by the College of Continuing Education.

I agree to the terms of this application.

If you have questions, please contact: Matthew Van Donsel.