CPhA 2014 Leader Development Institute (LDI) Application

To be considered for the LDI class of 2014, individuals must submit a completed application on or before 11:59pm on December 29, 2013. For more information about the 2014 LDI program, please click here.

If you have questions about this application, or about LDI in general, please direct them to Michael Negrete at michael@plei.org.

Form Login Account (optional)
New Users / Returning Users CLICK HERE to setup or return to your account for this form. Creating an account enables you to return to this form and your submitted results. An account will also enable you to partially complete this form and return later to finish the form. The account you establish is only for this form.

LDI Roles/Responsibilities

CPhA possess a strong desire and commitment to ensure that individuals who participate in LDI receive the greatest possible value from their experience. To help us determine the likelihood of your achieving the fullest possible experience, please indicate your level of confidence in being able to perform each of the following:

Physical Availability

* Attend all four of the in-person sessions
Sessions generally run from 10am-5pm and have been scheduled for February 22 in Sacramento; April 23 in Palm Springs; July 26, Location TBD (likely in Southern California); and November 7 in Monterey. Please note that any related travel/hotel costs are your own responsibility. (Attendees are encouraged to seek sponsorship/reimbursement from employers, local associations, etc.)
* Attend the following optional in-person experiences at your own cost (if applicable)
 Not at all confidentUncertainSomewhat confidentVery confident
CPhA's West Coast Pharmacy Exchange (April 24-27)
CPhA's Leadership Weekend (November 8-9)
Informal networking events during the evenings AFTER the live sessions
Informal networking events during the evenings PRIOR to the live sessions
* Actively participate in conference calls 1-2 times per month with your learning coordinator and 3-4 person peer group
Actual frequency and times of calls will be determined by your group.
* If the second LDI session was scheduled instead for April 28 (the Monday AFTER CPhA's Annual Conference vs. the Wednesday before), would it be easier or more difficult for you to attend?

Cognitive Availability

"Vision" is one trait commonly attributed to great leaders. At its most basic level, "vision" is simply the ability to see, or more broadly, to perceive. Since the vast majority of people who can see are not great leaders, there must be something different about the way great leaders see and perceive. A big part of LDI is helping participants see things differently. To help us deliver a program that will be a good fit with its participants, please indicate your level of confidence in being able to perform each of the following. (Please note that we are not asking about your CURRENT practices, just about your perceived ability to perform these tasks within the structure of a leader development program).
* Routine exercises to examine your current attitudes and beliefs (self reflection, journaling, etc.)
* Considering ways of thinking that may be out of alignment with your current attitudes and beliefs
* Trying out and evaluating new ways of thinking and behaving through the creation and management of an informal personal development plan
* Trying out and evaluating new ways of thinking and behaving through the pursuit of an identified "project".
Applicants should not let the notion of a project intimidate them. Projects can be big or small, or related to something you are already pursuing in your personal or professional life. All we ask is that your project in some way seek to create a sense of meaning, community, and enjoyment for you; and ideally for other members of CPhA as well.
* Sharing personal successes and challenges (one-on-one or in a small group), and being open to coaching

Financial Availability

* Travel/Hotel costs and incidentals
As discussed above, any costs incurred related to an individual's participation in LDI is the responsibility of that individual. PLEASE RATE YOUR LEVEL OF CONFIDENCE IN BEING ABLE TO COVER ANY SUCH COSTS either personally, or through the assistance of a personally identified sponsor (e.g. your employer or local association).
* Tuition
Tuition for the entire yearlong program is $1,850 for CPhA members and $2,250 for non-members. (One year of membership is included in the non-member rate). For 2014, CPhA is generously providing 18 select participants with scholarships to cover all tuition costs except for a $300 nonrefundable deposit ($700 for nonmembers) which must be paid by participants within 10 calendar days of being notified of their acceptance to the program. Upon successful completion of the yearlong program (which includes attendance at every live session), CPhA will apply the value of the deposit (up to $300) towards the graduate’s registration fee for the 2015 West Coast Pharmacy Exchange.

Now, Tell Us About YOU!


CPhA's goal is to enroll a class of diverse individuals. We want this group to be diverse in its thoughts and perspectives, as well as in its professional experience (as it relates to both scope and duration). To assist our efforts in achieving this diversity, please provide the following information:
* What's your CPhA Member Type?

Leadership Experience & Aspirations

Thank You!

If there's anything else you'd like to tell us, please do so below. Otherwise, just hit the "SUBMIT" button and you're done. Note that applicants will be notified of their admission decision via email by January 10, 2014. Until a final determination is received, applicants are advised to reserve the previously listed dates for the in-person sessions.
* Indicates Response Required