Columbus Consolidated Government
Leadership Development Program
APPLICATION FORM
Applications are Due August 17, 2018
Applicant’s Information
Last Name First Name Middle Name
Department Division Position
Years Months Yes No
How long have you been employed with the CCG? Are you a regular full-time employee?
Male Female
Gender Phone Number Email
Is there any training (i.e. Word, Excel, Leadership) you have completed within the last year? If so please list in space above.
Division Chief Information
Last Name First Name
Department Division
Phone Number
I authorize you to provide the Leadership Development Program Selection Committee with information
regarding my admission to the program.
Applicant’s Signature Date
click to sign
signature
click to edit
In the space provided below, answer the following questions. If more space is needed,
please attach sheets.
1. What do you think you personally need to work on to help you grow as a leader, and how
do you think the LDP will help with that growth?
2. Please describe in detail an occasion when you demonstrated leadership. (Does not have
to be work related.)
3. If we asked those with whom you work to describe your working style, what would they
tell us?
4. What is your favorite quote or saying about leadership?
To Be Completed by Your Department Director:
This serves as my permission for ______________________________ to attend the Leadership
Development Program. I understand that this is a free program provided by Columbus
Consolidated Government, however my Department will cover the $35 per applicant
assessment fee. This assessment is given in conjunction with the Myers-Briggs Session.
I also understand that this is a two-year program that will require ________________________
to be in session for 4 hours in the classes that will take place twice a month.
Department _____________________
Printed Name: _________________________________
Signature: ____________________________________
click to sign
signature
click to edit