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NY State AFL-CIO/Cornell Union Leadership Institute

16 E. 34th Street, NYC 212.340.2827

Participant Application Form

The nominee should fill out and submit this form by April 1.
Please complete all fields in the form.

Applicant Information

Applicant Name:

Sponsoring Union:

Local:

Union Position:

Number of years in position:

Applicant Contact Information

Home

Street Address:

City:

State:

Zip Code:

Telephone:
(with area code)

Email:

Union

Street Address:

City:

State:

Zip Code:

Telephone:
(with area code)

Employment History

Please provide information about your last three employers.

Employer:

Title/Nature of Position:

Dates of Employment:

Employer:

Title/Nature of Position:

Dates of Employment:

Employer:

Title/Nature of Position:

Dates of Employment:

Educational Background

Level of education attained:

High school or high school equivalency
Some college
College degree
Some graduate school
Graduate degree

Specify other professional/vocational training, if any:

Questions

Please answer the following questions as completely as possible.

Leadership Duties and Experience

1. Describe the leadership role you play in your union. What responsibilities do you currently have?

2. What other leadership positions have you held within your current union and other organizations?

3. Do you supervise staff? If so, please explain how many people you supervise and list their job titles.

Past Leadership Training

4. What prior leadership training have you had? List the courses/workshops and when and where you took them.

5. What formal training or educational experiences have you received in your union work?

Personal Goals and Expectations

6. What are your personal goals as a union leader?

7. How do you expect the Institute to benefit you?

Challenges Facing Union Leaders

8. What do you see as the major challenge facing New York union leaders today?

ULI Schedule

9. Do you expect any difficulties participating in the entire schedule of Institute seminars and activities? If so, please explain.

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