Preparing for Executive Leadership

Delegate Application Form

Personal Details

Title
First name
Last name
Telephone number
Email
Job title

Qualifications

Relevant qualifications
Please enter above the title and date of the highest qualification you have completed relevant to this application.
Other qualifications
Please enter the title, level and date achieved of any further relevant qualifications.

Additional Support Needs

Additional support needs
If you need extra support perhaps because of a disability, learning difficulty or any other issue please select Yes here and outline details below.
Details

Employer Details

Employer
Address line 1
Address line 2
Town/City
Postcode
Line Manager approved?
Please note that you MUST have the support of your Line Manager or other authorised person in your college before applying for this programme. Please supply the name and contatct details of this person below.
Name
Position
Email
Telephone
Personal statement
Please provide a brief history of your leadership journey so far and what you hope to get from this programme.

Declaration

Declaration

By typing my name here I declare that all the information provided in this form is accurate and that I have read and understood my responsibilities as a candidate as detailed below.

Delegate responsibilities
In registering to undertake this course with the CDN, I agree to:

  • complete the delegate induction process
  • commit to participate in 3 residential workshops
  • commit to self-directed study between workshops
  • engage in a collaborative strategic initiative with other delegates
  • engage in executive coaching for the duration of the programme
  • ensure all contact information is kept up to date and notify CDN of any changes
  • comply fully with all aspects of the CDN Equal Opportunities Policy
  • my consent being given for CDN to collect my personal details and to share these with the relevant awarding bodies for registration, achievement and certification purposes.

You can learn more about how CDN protects your information by clicking here.

How did you hear about this course?
Details
If 'other' selected please detail here