Executive learning Application Form

EXECUTIVE LEARNING SERIES

APPLICATION FORM

I SECTION - PERSONAL INFORMATION

1. Name and surname

2. Place and country of origin

3. Email address

example@example.com

4. Contact phone number

Country CodeArea CodePhone Number

5. Education

6. Name the media organization you work for and your current position within it

7. Explain the key roles / tasks you perform under this position

8. Please share links where we can find out more about you (website, social media, blog / vlog, podcast or similar)

II PROFESSIONAL INFORMATION

9. Did you participate in any similar programme? Or any programme that supports your media business development?

Yes or no

10. If yes, name the programme and its implementer

11. Please list and elaborate up to three professional accomplishments, engagements and / or experiences within the media you lead / work for that include innovation, collaboration, and introduction of new practices

Up to three sentences about each

12. Please list up to three of your personal initiatives, accomplishments, professional skills and/or values that you are proud of within the media you lead / work for and elaborate each of them

Up to three sentences about each

13. What kind of challenges are you facing in your professional work and what kind of support do you need?

14. In which direction do you want to develop professionally and personally?

III MEDIA STRATEGIC INFORMATION

15. How do you see the media you lead / work for in the next 5 years?

Describe as much as possible, visualize how your media look in the future in terms of its strategy positioning and services delivery

16. Name three positive changes you would like to see for your media in the future

17. What are three key challenges your media is facing right now?

18. What are three key strengths your media possess in order to achieve above mentioned goals?

IV PROGRAMME - MOTIVATION AND COMMITMENT

19. Why do you want to join the Programme? What is your key motivation?

20. What are your key needs - list up to 3 gaps you want to fill in terms of your media development through this Programme?

21. What do you expect to achieve throughout this Programme in the terms of knowledge, professional development, networking and in terms of your media development?

List 3 key types of knowledge, skills, etc.

22. Why do you think you are a good candidate for this Programme? Please elaborate as concrete as possible?

Max. 500 characters

23. Are you able to fully participate in all segments of this Programme (traveling to attend all three on-site workshops in countries of the CEE and WB, each workshop will be a two-day event, follow-up tasks, and actively taking part in online sessions throughout the 10 weeks period)?

Note: The program consists of connected sequences of learning and events and you should commit to all of them.

24. Do you have a good command of spoken English so you can follow the program fully in English?

I have a good command and can communicate with my potential mentor in English;No, my English is not at that level, and I will need additional support.

25. Application should be complemented with applicant’s CV that include current position, description of the role, as well as clear references to previous working experiences *

Date

Signature