Advanced Tech Leaders Application 2021 -22
You must apply to participate and participation is limited. It is mandatory that participants attend at least six of the seven sessions to complete and graduate from the program.The application deadline is September 30, 2021. Applicants will be notified of their selection into the Advanced Tech Leaders Academy by no later than October 8, 2021. Applicants are encouraged to reapply the following year if they are not selected. Any questions contact: Monika Philp // Director of Tech Leadership Development //

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Contact Information
First Name *
Middle Initial
Last Name *
Title *
Company *
Company Address Line 1 *
Company Address Line 2
City *
State *
Zip-Code *
Phone *
Work Email *
LinkedIn Account
Describe your current position and main responsibilities at work: *
What are some professional challenges you face today in your current IT role? *
List three characteristics that are essential for an IT manager to possess in order to be successful: *
What are you hoping to achieve through the Advanced Tech Leaders program? *
Please list any leadership or management development programs attended: *
Please give a brief description of your career objectives: *
Which (if any) assessments have you taken already?* *
Accountability Partner
Please select someone from your organization to serve as your Accountability Partner (AP) during the program. Your AP will spend time with you each month discussing the session and finding ways to implement the session concepts within your work environment.
Name *
Email Address *
Title *
Employer/Manager Name *
Employer/Manager Title *
Employer/Manager Email *
Class Roster Photo *
Do you plan on attending in-person or virtually? *
Participant Conditions *
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