FELLOWSHIP PROGRAM FELLOW APPLICATION

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FELLOWSHIP PROGRAM 2016 17 FELLOW APPLICATION

FELLOWSHIP PROGRAM ABOUT THE PROGRAM The Continuing Care Leadership Coalition (CCLC) Fellowship Program is a health care management experience designed to provide a first job experience for college graduates, and is supported by CCLC and its members. The program is a year-long, paid experience during which fellows are mentored by senior management staff at CCLC member organizations to gain firsthand experience with operations and management issues in long term care organizations. PURPOSE The program seeks to develop a pathway for top-notch college graduates to experience working in the field of long term care, to understand the challenges of caring for older and disabled individuals, and to develop a passion for the field through a coordinated program at CCLC organizations. ELIGIBILITY Applicants applying for this program for the 2016 17 year must meet the following criteria: Must be a graduate as of Spring 2016 Must have a strong academic record of 3.0 or better on a 4.0 scale Must show a sincere interest in a career in health care management Must demonstrate excellence in extracurricular and community service activities Must be a US citizen or hold a permanent resident visa Only first-time participants will be considered for the program. THE PROCESS Phase 1: Completed applications are reviewed and candidates are selected for an interview with CCLC. Phase 2: Students who successfully complete the CCLC interview are selected for a second round of interviews with our participating member organizations. Interviews at member organizations are based on the interest of the student and organizational preceptor availability. Phase 3: Students accepted by both CCLC and the member organization are formally admitted into the CCLC Fellowship Program. Placement depends on which organizations participate in the program. Our members are located in New York City and the greater metropolitan area. CCLC will also make an effort to choose a location that is convenient by car or public transit for the student. Accepted students will attend a formal orientation from CCLC at the start of the program. In addition to the program orientation, students will individually work with their host organization to process the appropriate documents for their employment. 1

2016 17 CCLC FELLOWSHIP PROGRAM WHAT TO EXPECT The Project: Each fellow s experience will be unique, but all fellows will work with a primary preceptor for the duration of the year. The preceptor will guide the fellows through departmental rotations and projects at their host organization. CCLC fellows will give a presentation about their projects and experiences to CCLC staff and long term care organizations at the end of the year. Mentorship and Networking: Each fellow will receive mentorship throughout the program by their preceptor and CCLC. Fellows will also have the opportunity to meet with various leaders and experts in the health care industry through educational sessions at CCLC. Paid Fellowship: The fellowship is paid. The annual salary, which will be at least $30,000 plus benefits, is determined by the student s host organizations. CCLC does not play a role in determining compensation. Lodging: Fellows are responsible for finding their own housing for the duration of the year-long fellowship. CCLC does not provide housing for fellows. COMMITMENT Students must be available Monday through Friday, from 9:00 a.m. to 5:00 p.m. It is mandatory for students to attend the CCLC orientation and educational sessions in the metropolitan New York area. Date* December 31, 2015 February March 2016 April 2016 June July 2016 December January June July 2017 Event Application Deadline; applications must be postmarked by this date Interviews with CCLC and potential fellowship site Matching process complete (fellowships assigned) Program begins/half-day orientation at CCLC in New York City Mid-year educational session Final educational session and program ends * All dates are subject to modifications. 2

CONTINUING CARE LEADERSHIP COALITION FELLOWSHIP PROGRAM APPLICATION INSTRUCTIONS Please complete this application by typing or printing legibly. If you need more space, please use additional sheets and identify each answer using the corresponding letters on the application. A resume or curriculum vitae is not an acceptable alternative to a complete application. Please refer to the checklist at the back of this booklet to ensure that your application is complete. This program supports diversity and inclusion in health care management. Members of minority communities are strongly encouraged to apply. Submit applications to jobs@cclcny.org with CCLC Fellowship in the subject line, or mail to: Roxanne Tena-Nelson, Senior Advisor, Continuing Care Leadership Coalition, 555 West 57th, 15th Floor New York, NY 10019. Application deadline: December 31, 2015 PERSONAL INFORMATION Name: Last Name First Name Middle Name Are you prevented from lawfully working in this country because of visa or immigration status? Yes No (Proof of citizenship or immigration status will be required upon employment.) Present Address: Apt Home Phone Work Phone E-mail Address Permanent/Parents Address: Apt Home Phone Work Phone E-mail Address Mailing Address: Present Permanent/Parents Other (Please enter information below.) Apt 1

2016 17 CCLC FELLOWSHIP PROGRAM APPLICATION (CONTINUED) ACADEMIC INFORMATION In addition to completing the information below, you will be required to submit proof of enrollment in your undergraduate school program (letter from the school indicating enrollment status), as well as all official transcripts from all schools attended. I am classified as a: Full-Time Undergraduate Student Part-Time Undergraduate Student Number of Hours Undergraduate Information: Name of Academic Institution Major Grade Point Average (cumulative) Date of Graduation Dates of Attendance: to Term Dates: Classes End For Spring 2016 TRANSPORTATION AND HOUSING REQUIREMENTS Applicants to this program will be placed in New York City or in the surrounding area. Fellows are responsible for obtaining housing in New York City or in the surrounding area. Some of the placements within the program are outside New York City for example, Long Island. In the event that you are placed in one of these sites, would you have access to a car? Yes No PERSONAL STATEMENT On a separate sheet of paper, please prepare a personal statement, maximum of 500 words, stating the following: Interest in health care management Experience to date, including work and service history Career goals Three major objectives for your fellowship RESUME Please provide your resume as a separate component. TRANSCRIPTS Send complete official transcripts from all colleges and universities. Official transcripts may be sent by mail or electronically to jobs@cclcny.org. RECOMMENDATIONS Choose at least three (3) people as references who are knowledgeable about your abilities and performance. Select at least one faculty member, one supervisor, and one volunteer community service supervisor. Recommendations are not limited to these individuals. Personal recommendations from family members or friends will not be accepted. 2

2016 17 CCLC FELLOWSHIP PROGRAM APPLICATION (CONTINUED) Print your name on the reference form included in this application packet and send one to each of your references. The reference forms may be copied. To ensure prompt processing of your application, please follow up with your references to be certain they return the completed forms to you, or submitted directly to CCLC, before the application deadline ONLY COMPLETE APPLICATIONS WILL BE REVIEWED. THERE WILL BE NO EXCEPTIONS. I certify that the information given herein is true and complete to the best of my knowledge. I authorize verification of all information in this application as it relates to the selection process. Signature Date How did you hear about the CCLC Fellowship Program? Career Counseling Office Website (please indicate): Other (please indicate): 3

CCLC FELLOWSHIP RECOMMENDATION FORM Your name has been given as a reference for the applicant whose name appears on this form. Your comments are confidential and will be reviewed by the Continuing Care Leadership Coalition (CCLC) Fellowship Selection Committee. Please return the recommendation form and letter of recommendation in a sealed envelope to the applicant who requested it from you, or e-mail it directly to jobs@cclcny.org. Student applications and recommendation forms must be received or postmarked by Thursday, December 31, 2015, to be considered. If you have any questions about this recommendation form, please contact Roxanne Tena-Nelson at (212) 258-5330 or jobs@cclcny.org with Fellowship Reference in the subject line. Thank you for your efforts on behalf of this applicant. The CCLC Fellowship is a health care management experience designed to provide a first job experience for college graduates, and is supported by the CCLC and its members. The program is a year-long, paid experience during which fellows are mentored by senior management staff at CCLC member organizations to gain firsthand experience with operations and management issues in long term care organizations. The CCLC Fellowship Selection Committee is interested in learning about this applicant s: ability to be successful in a professional working environment past success, whether at school, in the work place, or in the community, and interest in and commitment to health care management. Applicant Name Evaluator s Name Evaluator s Title School/Agency Phone Signature Fax Date RATING SCALE Please complete the rating scale below and submit along with letter of recommendation for the applicant. Categories Superior Good Average Poor N/A Leadership Skills Critical Thinking Ability Motivation Oral Expression Empathy For Others Ability To Work With Others Self-Confidence Maturity Reliability And Responsibility Breadth Of Intellectual Interest 4

CCLC FELLOWSHIP RECOMMENDATION FORM Your name has been given as a reference for the applicant whose name appears on this form. Your comments are confidential and will be reviewed by the Continuing Care Leadership Coalition (CCLC) Fellowship Selection Committee. Please return the recommendation form and letter of recommendation in a sealed envelope to the applicant who requested it from you, or e-mail it directly to jobs@cclcny.org. Student applications and recommendation forms must be received or postmarked by Thursday, December 31, 2015, to be considered. If you have any questions about this recommendation form, please contact Roxanne Tena-Nelson at (212) 258-5330 or jobs@cclcny.org with Fellowship Reference in the subject line. Thank you for your efforts on behalf of this applicant. The CCLC Fellowship is a health care management experience designed to provide a first job experience for college graduates, and is supported by the CCLC and its members. The program is a year-long, paid experience during which fellows are mentored by senior management staff at CCLC member organizations to gain firsthand experience with operations and management issues in long term care organizations. The CCLC Fellowship Selection Committee is interested in learning about this applicant s: ability to be successful in a professional working environment past success, whether at school, in the work place, or in the community, and interest in and commitment to health care management. Applicant Name Evaluator s Name Evaluator s Title School/Agency Phone Signature Fax Date RATING SCALE Please complete the rating scale below and submit along with letter of recommendation for the applicant. Categories Superior Good Average Poor N/A Leadership Skills Critical Thinking Ability Motivation Oral Expression Empathy For Others Ability To Work With Others Self-Confidence Maturity Reliability And Responsibility Breadth Of Intellectual Interest 5

CCLC FELLOWSHIP RECOMMENDATION FORM Your name has been given as a reference for the applicant whose name appears on this form. Your comments are confidential and will be reviewed by the Continuing Care Leadership Coalition (CCLC) Fellowship Selection Committee. Please return the recommendation form and letter of recommendation in a sealed envelope to the applicant who requested it from you, or e-mail it directly to jobs@cclcny.org. Student applications and recommendation forms must be received or postmarked by Thursday, December 31, 2015, to be considered. If you have any questions about this recommendation form, please contact Roxanne Tena-Nelson at (212) 258-5330 or jobs@cclcny.org with Fellowship Reference in the subject line. Thank you for your efforts on behalf of this applicant. The CCLC Fellowship is a health care management experience designed to provide a first job experience for college graduates, and is supported by the CCLC and its members. The program is a year-long, paid experience during which fellows are mentored by senior management staff at CCLC member organizations to gain firsthand experience with operations and management issues in long term care organizations. The CCLC Fellowship Selection Committee is interested in learning about this applicant s: ability to be successful in a professional working environment past success, whether at school, in the work place, or in the community, and interest in and commitment to health care management. Applicant Name Evaluator s Name Evaluator s Title School/Agency Phone Signature Fax Date RATING SCALE Please complete the rating scale below and submit along with letter of recommendation for the applicant. Categories Superior Good Average Poor N/A Leadership Skills Critical Thinking Ability Motivation Oral Expression Empathy For Others Ability To Work With Others Self-Confidence Maturity Reliability And Responsibility Breadth Of Intellectual Interest 6

CCLC FELLOWSHIP APPLICATION CHECKLIST Use the following list to be sure that you have all the documents needed to be considered for participation in the CCLC Fellowship Program: Original application and all other required documents. (Only properly completed applications will be considered.) Proof of enrollment in an undergraduate school program (letter from your college or university indicating enrollment status). Complete official transcripts from all colleges and universities attended. Official transcripts are sealed by the school or electronically submitted from the school. Personal statement, maximum of 500 words, stating: Interest in health care management Experience to date, including work and service history Career goals Three major objectives for your fellowship Three (3) completed Recommendation Forms submitted by a faculty member, employer, volunteer service supervisor, or an equivalent source. Complete resume, including volunteer and community service experience. Submit application and all other required documentation to jobs@cclcny.org or mail to: Roxanne Tena-Nelson Continuing Care Leadership Coalition 555 West 57th, 15th Floor New York, NY 10019 APPLICATION DEADLINE: DECEMBER 31, 2015