2026 LeadingAge Ohio Leadership Academy Application

Applicant & Applicant's Employer Information:

First Name
Last Name
Name for Name Badge
Preferred Pronouns (she/her, he/him, they/them, etc.)
Job Title
Organization
Organization Address
 
City
State
Zip
Email
Mobile Phone
Select the area of the continuum that best describes the site or community where you are employed/where you perform your primary job responsibilities:
Adult Day Services
CCRC/Life Plan Community
Corporate Office
HUD/Affordable Housing
Home Health/Home Care Agency
Hospice/Palliative Care
PACE
Assisted Living (non CCRC)
Nursing Home (non CCRC)
Housing/Independent Living (non CCRC)
Other (Please specify.)

Summary of Qualifications

Tell us a little about your background in aging services and what you do in your current role.
What makes your organization unique? (examples: urban/rural location; who you serve; innovative programming)
Are there other organizations or activities you are part of that highlight who you are or show your leadership potential?
I acknowledge that if at any time my employment status changes, I am no longer employed by the supporting organization or I fail to meet any of the program’s eligibility criteria, continued participation in the Leadership Academy is subject to review by LeadingAge Ohio.
I acknowledge that I must submit a resume to rhamill@leadingageohio.org that includes at least three of my most significant formal and/or informal leadership roles throughout my career that have contributed to leadership development, educational background and other pertinent information.
I acknowledge that I am required to obtain two letters of reference and send to rhamill@leadingageohio.org. Please approach selected references early in the process to ensure their letters are completed and submitted prior to the November 12, 2025 deadline.

Sponsorship:

As part of our goal to broaden access to leadership development, LeadingAge Ohio will be offer two tuition scholarships to fellows from member organizations that are new to Leadership Academy or have not participated in recent years. This is a competitive scholarship, and candidates will be reviewed based on the quality of their application, as well as personal and professional experiences that will lend breadth and diversity to the class of 2026.
Sponsoring organizations will still assume responsibility for travel and lodging expenses, as well as granting time for Academy learning sessions and projects.
I would like to be considered for the tuition scholarship and affirm that this is my organization's first time sending someone to Leadership Academy OR it has been more than five years since a staff member has attended Academy.

Leadership Journey:

1. Tell us about the qualities that make you an effective leader and how you’ve demonstrated them in your personal or professional life. Please include one significant professional achievement, your role in it, and the impact it had on your organization.
2. What perspective or knowledge are you hoping to gain from the Leadership Academy? How do you see these insights helping you grow as a transformational leader?
3. Share your journey into the field of aging services. What keeps you passionate about this work, and what is your vision for the future of aging services?
4. Is there anything else you’d like us to know that highlights your commitment to leadership growth?

Applicant Statement of Commitment:

The Applicant Statement of Commitment provides the basis for a commonly held understanding between the applicant and LeadingAge Ohio about eligibility criteria and participant expectations.
If selected, I agree to:
1. Attend all four, two-day program sessions. If I am unable to attend a session, I will submit a written request from my sponsoring organization to LeadingAge Ohio.
2. Complete all readings and assignments, including group projects, journaling, and action learning projects, to fully engage with and apply the program content.
3. Connect monthly with my Leadership Academy coach to discuss assignments, progress on action learning projects, and further explore leadership concepts.
4. Notify a Leadership Academy Design Team member promptly if I am unable to meet any participation or assignment requirements, and work with them to identify alternate arrangements to stay on track.
5. Understand that if my employment status changes, I leave my sponsoring organization, or I no longer meet the program’s eligibility requirements, my continued participation in the Leadership Academy will be subject to review by LeadingAge Ohio.
I am agreeing to the terms and conditions for the Statement of Commitment indicated above.
Initials of Applicant

Sponsoring Organization's Statement of Commitment:

In addition to this application, a Statement of Commitment signed by the CEO or Executive Director of your organization is required. If you are the highest-ranking executive officer, the organization’s board chair must complete the form.
Use this link to access the Statement of Commitment form for your organization to complete:
Statement of Commitment for Sponsoring Organizations
   - denotes required fields

Our national partner, LeadingAge, is an association of 6,000 not-for-profit organizations dedicated to expanding the world of possibilities for aging. Together, we advance policies, promote practices and conduct research that support, enable and empower people to live fully as they age.