CPhA 2014 Leader Development Institute (LDI) Application

image
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

 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

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).

Financial Availability

Now, Tell Us About YOU!

Demographics

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:

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