MPLA Handbook - NHS Leadership Academy



Aspirant Directors of Public Health Leadership ProgrammeSponsor nomination form for cohort 1In order to ensure that the applicant’s application is complete, please submit this sponsor nomination form by 12pm on 14 December 2012 to aspirantDPH@deloitte.co.uk. Sponsors do not need to wait until the applicant has completed their form before submitting the sponsor nomination form as these can be completed simultaneously and submitted separately. Sponsors do not need to share their sponsor nomination form with applicants but it is advised that applicants share their application forms with sponsors. The information you provide on this form will be used to understand whether the applicant is suitable for the Aspirant Directors of Public Health Leadership Programme. It will also be used to inform the detailed design of the programme, ensuring that the programme is focused on the development areas of participants. Before completing this form, please be reminded of the participant eligibility criteria. The programme is intended for those who:are highly committed to becoming a Director of Public Health within a local authority and envisage applying for this post in the next 12 months, or who have recently been appointed to this post for the first time;are committed to learning about leadership and making behavioural changes that impact on improving the health of local populations; andare able to commit to the programme dates.We would ask you to be as objective as possible and to satisfy yourself that any applicant you support will benefit from and contribute to the programme, and that you are confident that they will apply to the role of DPH within the next 12 months albeit with some development. More information about your role as a sponsor can be found in the sponsor information pack. If you have any questions or concerns, please contact the programme team at aspirantDPH@deloitte.co.uk Sponsor informationFull name of the sponsor: FORMTEXT ????? Organisation: FORMTEXT ?????Job title: FORMTEXT ?????Work address: FORMTEXT ?????Phone: FORMTEXT ?????Mobile: FORMTEXT ?????Preferred email address for correspondence: FORMTEXT ?????Applicant name: FORMTEXT ????? Applicant organisation: FORMTEXT ?????Region:North West FORMCHECKBOX East of England FORMCHECKBOX North East FORMCHECKBOX London FORMCHECKBOX Yorkshire and Humber FORMCHECKBOX South West FORMCHECKBOX East Midlands FORMCHECKBOX South East FORMCHECKBOX West Midlands FORMCHECKBOX SponsorshipWhy do you think that the applicant is ready for further development through the Aspirant Directors of Public Health Leadership Programme? (max 250 words) FORMTEXT ?????What do you see as the main strengths of the applicant in relation to the requirements of a Director of Public Health within a local authority? (max 250 words) FORMTEXT ?????What do you see as the main development areas of the applicant in relation the requirements of a Director of Public Health within a local authority? (max 250 words) FORMTEXT ?????Are there any additional areas that this form has not identified which you think may be helpful in assessing the applicant’s suitability for the programme? FORMTEXT ?????Sponsor signatureIn sponsoring this applicant to participate in the programme I confirm my belief that they are suitable for the programme and that they have my full support whilst on the programme. Please use an electronic signatures Signature: FORMTEXT ?????Date: FORMTEXT ????? ................
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