HR Leadership Program

HR LEADERSHIP PROGRAM APPLICATION

Use this form to apply for consideration to the HR Leadership Program. Complete all sections fully and sign the certification at the end. Submission of this application does not guarantee selection. By applying, the applicant agrees to the terms and authorizations stated in the Legal Disclosures and Applicant Certification sections below.

Personal Information

Applicant Name:

Employee ID:    Current Job Title:

Work Location:    Department:

Supervisor / Reporting Manager:    Manager Email:

Work Phone:    Personal Email:

Position & Employment Details

Date Hired (company):    Current Annual Salary:

Employment History

Job Title:    Dates Employed:

Job Title:    Dates Employed:

Education & Training

Graduation Date:    Major / Concentration:

References (Professional)

Phone:    Email:    Relationship:

Phone:    Email:    Relationship:

Phone:    Email:    Relationship:

Program Statement & Objectives

Time Commitment: I acknowledge the program requires approximately  and I am able to participate during the program period.

Willing to travel for mandatory sessions: Yes No

Legal Disclosures & Authorizations

At-Will Employment: Participation in the HR Leadership Program is separate from any change in employment status. Nothing in this application or in program materials alters the at-will employment relationship between the employee and the employer, unless an explicit and signed agreement states otherwise.

Equal Opportunity: The organization maintains an equal opportunity policy. Selection for the program will be based on objective criteria related to program goals and participant qualifications. The organization does not discriminate on the basis of protected characteristics.

Authorization to Contact and Background Check: By submitting this application I authorize the organization to contact current and former employers, listed references, and educational institutions to verify the information provided and to obtain background information relevant to program participation. I further authorize the release of such information to the organization and its authorized agents for the purpose of evaluation for the HR Leadership Program.

Confidentiality and Intellectual Property: I understand certain program materials, assignments, and discussions may be considered confidential. I agree to maintain confidentiality of proprietary materials and to assign to the organization, without further consideration, any work product or inventions created in the scope of program assignments, to the extent required by applicable policy.

Acknowledgements:

I acknowledge and accept the At-Will Employment statement.

I acknowledge the Equal Opportunity statement.

I authorize the organization to contact references, prior employers, and educational institutions and to conduct background checks as necessary for program evaluation.

Applicant Certification

I certify that all information provided in this application and any attachments is true, complete, and correct to the best of my knowledge. I understand that falsification, omission, or misrepresentation of information may result in disqualification from the program or subsequent disciplinary action. I agree to comply with program requirements, including attendance, assignments, and confidentiality obligations.

By checking the box below and signing, I attest that I have read, understand, and accept the terms, disclosures, and authorizations contained in this document.

I certify the statements above and authorize this application for consideration.

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