EHL Application

Application Form

Thank you for your interest in the Health Leadership Academy’s Emerging Health Leaders Program.

The Emerging Health Leaders Program is an intensive 14-day leadership development program. The admissions committee will review each application and provide letters of acceptance on a rolling basis. All questions about the program or application process can be directed to An Kuye at kuyea@mcmaster.ca

Please note: To ensure your application is received successfully, please ensure you are using recent Google Chrome or Safari browsers when completely this application. A representative from the Health Leadership Academy will be in contact with you upon receipt of your application to ensure it has been successfully received and completed.

Personal Information

First Name
Last Name
Email Address
Telephone Number

Current Employment

Academic Information [if applicable]

University
Program
Faculty
Year of Study
Specialization

How Did You Hear About Us? (Select all that apply)

(Hold down the CTL key to select more than one option):

Faculty Member/Professor. Please Specify Name:

Other Referrer (i.e. Alumni, Colleague). Please Specify Name:

Preferred Session

SPRING: April 28 - May 11, 2019SUMMER: August 11 - 24, 2019

I would like to be considered for both sessions.

Preferred Accommodation

Written Responses

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



2) Describe a challenge that you had to overcome. What did you do and what did you learn?

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):

Bursary 1

Please attach your bursary application below, if interested (.docx or .pdf):

Bursary 2

Please attach your bursary application below, if interested (.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.