Career Advancement Programme

Application Form

You should allow about 30 minutes to complete all the questions.  As well as your needs and ambitions for the programme, you will also need to record the contact details (including any payment reference or code) of the person to whom the invoice for the programme should be sent.  All information you supply will be treated in confidence.

Background Information

	Your Full Name

	Current Job Title

	Current Organisation

	Mobile:

Preferred Contact Points for the Programme

	Address:

	Postcode:

	Email:

	Landline:

1.	How did you first hear about this Programme?
	--Click Here--previous participant in the programmeline managercolleaguee mail communicationwebsitearticlejournal advertother

2.	Which of the following career development experiences have you been engaged in during the last five years?
	Career Coaching		Assessment Centre		Other  (please specify below)
	Other Coaching		Leadership Development Programme
	Career Seminar/Tutorial		Mentoring

	Please outline the development opportunities below e.g. name, organisation, content and  your learning

3.	Briefly describe the series of events that led to your decision to apply for this Programme?

4.	How do you best learn? What kind of techniques do you like to use?

Needs Assessment

5.	How important are the following career priorities to you?
		Very important		important		quite important		not at all important		don't know/perhaps
	I need to know where I should go next in my career
	I want to change jobs
	I want to add new dimension to my career e.g. managerial, clinical, technical
	I want to advance in my current career further
	I want to change career direction
	I want to reach an executive position
	I want to plan for my retirement
	I want to change sectors
	I am at risk and need to plan my next move

	What other priorities you have for your career?

6.	By the end of the programme, how important is it that you ...
		very important		important		quite important		Not important at all
	have reviewed your career direction and choices?
	know how to recognise new career opportunities?
	have a plan to achieve your career goals?
	have fresh material for applications and interviews?
	are more able to manage the application process?
	have an up-to-date Curriculum Vitae?
	are more able to write applications for employment?
	are more able to tackle selection processes?
	are more confident and/or proficient at interviews?
	have a better home-work balance?
	are more motivated and engaged at work?

	List here anything else that is important for you to have achieved:

7.	What is your overall goal for this programme?

8.	What are your expectations of the career consultant who will work with you during the programme?

Access

9.	Would you like us to request on-site car-parking for your sessions?	Yes
		No

	Our premises are fully accessible for people with physical disabilities.  However, should you have any other access requirements that we should be aware of (e.g. visual, audio or learning needs), please state them below.

	What other issues should we be aware of in order to ensure your achieve your programme goal successfully?

Prerequisites for Admission

10.	What information do you have available to send to Accomplice alongside your application
		I have submitted this to Accomplice		I will submit this to Accomplice on request		not available
	Most recent CV
	Current job description (and organisational structure)
	Most recent appraisal
	Personal Development Plan
	References
	360 Analysis e.g Leadership Qualities Feedback

	If known, what was your MBTI (Myers Briggs) type?

	If known, what were your Belbin Team Role Preferences?

	What other supporting information would you like to submit with your application?

	What other supporting information would you like to submit with your application?

11.	Outside the formal (one hour) sessions, how much time will you devote to career study each week?
	--Click Here--less than an houran hour1-2 hours

Fees

12.	To whom should the invoice for the fee be sent?
	--Click Here--YourselfYour OrganisationOther

	Full Name

	Organisation (if relevant)

	Address

	Postcode

	Telephone

	Other reference information

Feedback on this Activity

	How easy was it to complete this activity?
	How long did it take to complete this activity?

	Provide any other  Comments, Feedback and Advice below

On completion of this exercise, you are advised to print a copy for your records (Main Menu: File & Print).

Then, press 'submit' to send a copy to Accomplice.

br12_3_2 cap application form

©  www.accomplice.uk.com