Pathfinder Program Application

Personal Information

First Name
Last Name
Email Address
Alternate/Personal Email Address

Telephone Number

How Did You Hear About Pathfinder?

Select all that apply. Hold down the CTRL key to select more than one option.
If "Other" please provide:

If referral, please provide their name:
If another referrer (ie. alumni, colleague), please provide their name:

Have you taken a program with the Health Leadership Academy before?
YesNo
If yes, which one and in what year:

Written Responses

1) What are you hoping to gain from this program both personally and professionally?

2) Describe a challenge that you are currently facing. How will Pathfinder enhance your
leadership skills to allow you to tackle this challenge?
3) What unique perspective will you bring to this Pathfinder cohort?

4) Pathfinder participants get access to a leadership coach. What are some things that you might want to explore with your coach?

References

Please provide references that can speak to your leadership capability and success either personally or
professionally.

Reference 1

Name
Title
Organization
Relationship
Telephone Number
Email Address

Reference 2

Name
Title
Organization
Relationship
Telephone Number
Email Address

Resume

Please attach your resume below (.docx or .pdf):

* Please attach only docx or pdf files.

Applicants will be asked to participate in a personal interview. Those moving to the interview stage will be contacted directly.