2025 Application for Leadership Position

Application for Leadership Position
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
Email*
example@example.com
ACPE Involvement

Certain leadership positions require applicants to be active members in good standing. Please answer the following questions below:
Are you an ACPE Member in good standing?*

YesNo
Select your member type:*
Are you a member of a Community of Practice?*

YesNo
Please list the CoP's that you are a member of:
Please note that we will contact the CoP Coordinator for a reference.

Select the position(s) you are interested in (maximum of 3):

Review our Governance Manual for more information about our leadership positions.
Board of Directors*
Accreditation Commission*
*Must be an ACPE Certified Educator
Certification Commission*
*Must be an ACPE Certified Educator
Professional Ethics Commission**
*You must have completed the ethics training in order to be considered for a position on the ethics commission.
Psychotherapy Commission*
Finance Committee*
Leadership Development Committee *
Advocacy*
Curriculum/Educational Resources*
International Relations*
Professional Well-Being*
Research*

Professional/Leadership Experience:
Please attach your resume.*

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Please list your leadership experience in and out of ACPE: *
Please list the specific strengths and competencies that you possess that will make you a good fit for the ACPE leadership position(s) you are applying for:*
Information for Ballot:
Provide a vision statement of ACPE based on the challenges and growth we face over the next five years. Your statement will be included on the slate presented to the membership. *
2,000 character count limit
Provide a short bio written in the third person. Your bio will be included on the slate presented to the membership. *
2,000 character count limit
Upload a headshot for the ballot and leadership directory. *

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I understand that this application does not automatically ensure that I will be appointed to the position for which I have applied. All applicants are processed by the Leadership Development Committee and used to build a ballot for election by the membership. (Click and hold your mouse button to sign. Or use your finger if using a touchscreen.)*

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