SEP Application Save my progress and resume later | Resume a previously saved form Resume Later In order to be able to resume this form later, please enter your email and choose a password. Your Email: A Password: Confirm Password: It is assumed that you have already confirmed your availability for all of the program dates found in the brochure. Choose one:Please select... I am the strategic executive with my CEO's approval to apply I am the CEO (or equivalent) applying for my strategic executive Other About the Applicant About the Applicant First Name Last Name Title Email Phone Number GenderPlease select... Male Female Non-binary Non-conforming Two-Spirit I Prefer Not to Share Other Which do you self-identify as? (select all that apply)AsianAfricanAfrican Nova Scotian (As defined by African Nova Scotian Affairs)BlackCanadianCaribbean CanadianFirst NationInuk (Inuit)Indigenous from outside Turtle Island/North AmericaLatinxLGBTQIA2SMétis (i.e. members of the Métis Nation, namely, the Métis Nation of Ontario, the Manitoba Métis Federation, the Métis Nation—Saskatchewan, the Métis Nation of Alberta and the Métis Nation British Columbia)Middle EasternMulti-racialNewcomer (Immigrant)WhiteA person with a Disability (As defined under the Employment Equity Act)I prefer not to shareOther If choosing Other, please feel free to elaborate About the CEO Name Email Title (if not CEO) About the company Organization Name Street Address City ProvincePlease select... ALBERTA BRITISH COLUMBIA MANITOBA NEW BRUNSWICK NEWFOUNDLAND AND LABRADOR NORTHWEST TERRITORIES NOVA SCOTIA NUNAVUT ONTARIO PRINCE EDWARD ISLAND QUEBEC SASKATCHEWAN YUKON TERRITORIES Country Postal Code Number of Employees (Full Time Equivalent) Number of Employees reporting to Manager/Leader in question? (FTE) Preferred Program Format (Not Applicable for SEP16)Please select... I am only interested in the In-Person program I am only interested in the Virtual program I am interested in either program My Motivation to Apply This is the main item reviewed by the judges to select the 25 people who are interviewed with their CEO for one of the ~ 16 positions in the group. My Contribution It is important for each member to be able to both “give” and “get” from the group discussions. Share your top skill/experience that you would bring to the group as well as the top learning/growth you want to achieve as a result of your participation. After the application deadline, the Wallace McCain Institute will be in contact to book an interview with both the applicant and the "CEO" or equivalent. What is the name of the person to contact to book the interview? Their email? Privacy Policy - UNB and the WMI are committed to protecting the personal information of all applicants. The information collected on this application form will be used solely for the purposes of selection for this years’ SEP and will be accessible only to the judges (marked confidential) and WMI staff. For more information on the protection of personal information at UNB consult the University Secretariat, UNB, PO Box 4400, Fredericton, NB, E3B 5A3 www.unb.ca/secretariat (506) 453-4613. reCAPTCHA helps prevent automated form spam. The submit button will be disabled until you complete the CAPTCHA. Save my progress and resume later | Resume a previously saved form
