2027 PNAA iLDP Call for Fellows Application Form

Call for 2027 iLDP Fellows

Celebrating 10 years of Innovative Leadership
Email Address
example@example.com
Full Name as you would like it to appear in published material and on your certificate of completion

First NameLast Name
Phone Number where you can be easily reached or texted
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Nursing credentials, e.g. MSN, RN, CCM
Eligibility for consideration in the iLDP Program is current membership in PNAA until the COMPLETION of the Program. What is the expiration date of your PNAA membership? (see membership card accessible via PNAA Website)
Provide a copy of your current PNAA Membership Card

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PNAA Region
Local PNAA Chapter
Current Position in PNAA Chapter (member, president elect, past president, board member etc.)
Years of PNAA Membership
In no more than 150 words, please provide a personal statement expressing your fit for the 8-week iLDP Program and intent to engage as a Fellow.
Please upload a professional headshot for use in the learning management system, PNAA publications (flyers, websites, announcements, etc).

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iLDP T-Shirt Size

Other
If selected I will make myself available for iLDP Fellows Orientation on Wednesday April 7, 2027

Other
Will you commit to attending the iLDP Pinning and Graduation Ceremonies held during the National Convention July 19, 2027 on board the Hawaiian Convention Cruise? NOTE: This is HIGHLY recommended for complete in-person closure with iLDP peers and faculty. Put in your leave requests with your work settings NOW.

Other
This checklist helps our Program team understand what you need to participate fully in this eight-week online leadership development program. It asks about your time, technology access, work schedule, and support needs. ☐ This is not a test, and there are no right or wrong answers. ☐ Your responses will not be used to judge your leadership ability, clinical competence, or work performance. ☐ Responses are used only to plan orientation, Program materials, guide matching with faculty coach, and support before the program begins. ☐ Individual responses are seen ONLY by the program Co-Directors. ☐ Estimated time to complete: 10–15 minutes.
Section 1: Time and Work Schedule
1.1 Before answering, review the expected weekly workload for the iLDP: Expected weekly commitment: approximately 3-4 hours per week for 8 weeks, including: • Live online sessions: 4 cafe sessions, each 90 minutes, on every 1st Wednesday of each Module • 4, 2 weeklong Self-paced modules, weekly Discussion participation and assignments: approximately 3 hours/week.
1.2 Looking at your typical work and personal schedule, how many hours per week can you realistically set aside for the 8-week long iLDP?
1.3 Which aspects of your work schedule could interfere with participation? (Select all that apply.)
1.4 What days and times generally work best for you to study or attend live sessions?
Section 2: Technology and Access
2.1 What device(s) will you mainly use to access the program? (Select all that apply.)
2.2 How reliable is your internet access for participating in online learning activities (watching videos, joining live sessions, uploading assignments)?
2.3 Have you used an online learning platform before (for example, for continuing education, a degree course, or workplace training)?
2.4 Is there anything about accessing or using technology that would make participation harder for you?
Section 3: Live Sessions and Program Requirements
3.1 Review the live session schedule below, then respond. Live sessions: iLDP Cafe, 8 PM EST on April 14 & 28, May 12 & 26, 2027. Attendance is person is highly recommended to experience together guidance for the upcoming Modules and to ensure adequate critical mass for meaningful breakout session. Sessions are recorded and should not be interpreted as adequate replacement for in person attendance.
Can you attend the scheduled live sessions?
3.2 If you expect to miss sessions, what will help you stay on track? (e.g., recordings, alternative discussion participation, adjusted deadlines)
Section 4: Support and Environment
4.1 What support or schedule adjustments from your workplace would help you participate fully?
4.2 Who (if anyone) needs to approve or coordinate your participation (manager, educator, staffing office)?
Section 5: Learning Goals and Safe Discussion
5.1 What leadership challenge or situation would you like to work on the iLDP? (For example: leading a team/chapter through change, having difficult conversations, chapter quality improvement and/or innovative initiatives such as succession planning.)
5.2 In the iLDP, you will discuss workplace examples with other Program Participants. What guidance would help you share those examples without identifying patients, staff, or your organization?
5.3 What else should the program team know to support your participation?
Attestations:

1. I attest that once selected, I commit to actively engage in all the scheduled activities during the 8-week long program devoting approximately 3-4 hours/week, apply learning in my local and/or national roles, and willingly provide feedback for program improvement.

2. I attest that the information to all facts in this application are true to the best of my knowledge and give permission for said facts to be verified or used in various publication formats (i.e. website, FB page, Convention flyers)

3. Please sign in signature field.
Signature
Thank you and Congratulations! You have come to the END of the APPLICATION process. If you wish to review or edit previous sections, click on the "BACK" icon below AND NOT THE BROWSER BACK ARROW.

DO NOT HIT SUBMIT UNTIL YOU ARE ABSOLUTELY SURE YOUR APPLICATION IS COMPLETE. Once you hit SUBMIT your application is final AND CANNOT BE EDITED.

You can anticipate hearing from the iLDP Team between March 15-22, 2027.
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Call for 2027 iLDP Fellows

Section 1: Time and Work Schedule

Section 2: Technology and Access

Section 3: Live Sessions and Program Requirements

Section 4: Support and Environment

Section 5: Learning Goals and Safe Discussion