Leadership for the Government Supervisor 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.

The Portfolio Home

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

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

Applicant Demographic Information

Alum:

Are you a Sacramento State University Alum?

Yes No

Highest Level of Education: 80-hour state training:

I have completed the mandatory 80-hour state supervisory training.

Yes No Unsure

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 Supervisor?

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 25 - $3,329.00 (Deadline: 7/19/24)

Course Delivery: In-person at Sac State

Day 1 - Supervisor as a Leader: Wednesday, September 18, 2024

Day 2 - Effective Interpersonal Communication: Thursday, September 19, 2024

Day 3 - Essentials of Talent Management: Wednesday, October 16, 2024

Day 4 - Talent Development Strategies: Thursday, October 17, 2024

Day 5 - Developing Your Team: Wednesday, November 20, 2024

Day 6 - Organizational Change Applications: Thursday, November 21, 2024

Day 7 - Decision Making for Supervisors: Wednesday, December 18, 2024

Day 8 - Advanced Supervisory Development & Graduation: Thursday, December 19, 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.