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Nursing Education
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Faculty Programs & Resources

Nursing Education
Nursing Education
Nursing Education National League for Nursing - Faculty Development SENIOR DEAN/DIRECTOR LEADERSHIP PROGRAM - APPLICATION FORM 2015
Name (with credentials):
Home Street Address, City, State, Zip Code:
Home Telephone:
Name of Employer or School Where You Are an Administrator:
Street Address, City, State, Zip Code:
Work Telephone:
Previous Administrative Position(s):
Are you of Hispanic descent?
Yes No
Race: Please choose the category below that best describes the way you identify yourself.

Alaskan Native or American Indian

Asian (not underrepresnted)

Asian (underrespresented) *

African American or Black

Native Hawaiian or Pacific Islander




* Any Asian other than Chinese, Filipino,
Japanese, Korean, Asian Indian, or Thai
Gender: Male Female

Education (include basic preparation through highest degree held)


(Name, City, State)

Major Area of Study

Year Degree Awarded


If you are employed in a school of nursing, which types of programs are offered at that school? Select all that apply.

If you are employed in a school of nursing, in which programs do you generally have teaching, advisement, and leadership responsibilities?

Indicate the ONE program where you have the MAJORITY of your teaching, advisement, and leadership responsibility.







Present position and description of responsibilities, including those activities, operations or functions for which you are directly responsible. Include academic rank if appropriate.

What is the total number of years you have been in your current administrative position?

Previously held positions in nursing education (provide your title and/or rank, name of school, dates, location of school, and a brief description of responsibilities).

Other relevant employment or experience:


Please be concise when answering the following questions. One or two paragraphs for each question is sufficient. Be sure to answer all parts of each question.

1. Describe reasons why you think you need to be re-energized to lead?

2. What do you believe are two major challenges facing your institution?

3. What are the two most important challenges facing you in your position? What organizational system issues have affected your administrative role? What effective strategies have you implemented?

4. Identify up to three goals you wish to accomplish as a result of participating in this program.

5. In what ways do you anticipate your specific skills, experience, and perspective to contribute to this program?

Abbreviated Curriculum Vitae (limit to 3 pages)

Submit the following information as a separate document with your application as an abbreviated curriculum vitae (Do not submit your full curriculum vita!)

  1. Professional Education
  2. Professional Experiences - list position titles, institution/organization, locations, and inclusive dates
  3. Administrative/Management Experience - include academic programs
  4. Other Leadership Roles
  5. Publications
  6. Presentations
  7. Grants Awarded
  8. Membership in Professional Organizations
  9. Honors/Awards
  10. Other Leadership Programs Attended

Note: File names should start with, "seniordeandirector-CV_yourlastname".

Administrator's Letter

Please upload the appropriate administrator’s letter on school letterhead indicating the school’s support of your attendance, January - December 2015. This letter should include acknowledgement of payment of your conference fee, lodging and transportation, as well as support for participation in all activities.

Note: File names should start with, "seniordean_director-letter_yourlastname".

You will receive a confirmation email when your application is received and complete. If you do not receive an email within five business days of your submission, please contact the Tigist Bishaw at 202-909-2503.



  • Read through your application to be sure that you have completed all sections.
  • Submit your application as stated in the directions above.
  • Upload an abbreviated curriculum vitae that includes the above information.
  • Appropriate administrator's letter (e.g., provost/vice chancellor, dean) addressing your leadership abilities and documenting her/his support for your participation in this project. Applicants will not be considered if the appropriate administrator’s letter does not accompany the application.

All application materials must be received by September 30, 2015 at 5:00 PM ET.

Note: Please click only once, the form may take several seconds to process.


Nursing Education
Nursing Education
Nursing Education
Nursing Education