Leading Organizations Candidate Form

Currently recruiting for Fall 2023 Leading Organizations cohort. Deadline to complete this form is August 16, 2023. Please contact Patrick Seigler (Patrick.Seigler@des.wa.gov) for more information.

1. Please select the name of your agency or organization: *This question is required.

2. Candidate Contact Information *This question is required.

First Name
Last Name
Email
Phone
Job Title

3. Statement of Interest or Sponsor Recommendation (limit to 150 words)

4. Full engagement in the program is essential for the candidate and entire cohort's experience. This requires commitment from the candidate, the candidate's immediate supervisor and the agency. This program expects the following from September 2023 through March 2024:

Completion of A Path Toward Equity training in October (10 hours & virtual)
Orientation in September (30 minutes & virtual)
Participation onsite at 1500 Jefferson Nov 7&8, Jan 16&17, Mar 5&6 (48 hours & in-person)
Completion of intersession assignments (coaching, group project, course material review) (~20 hours & virtual/asynchronous)

Please confirm all parties understand and will support this time commitment. *This question is required.

5. Candidate's Immediate Supervisor Contact Information *This question is required.

First Name
Last Name
Email
Phone
Title

6. Agency Leading Organizations Liaison or Appointing Authority Contact Information *This question is required.

First Name
Last Name
Email
Phone
Title