2025-2026 Leadership Development Academy Application

APPLICATION DEADLINE: April 25, 2025
 
APPLICANT PROFILE
Full Name with Credentials
 
Hospital/Physician Group Affiliation
 
Number of years as an ACEP/EMRA Member
 
Residential Mailing Address
 
Preferred Phone
 
Preferred Email
APPLICANT QUESTIONS
1. List any state or national activities in which you have participated (leadership positions, committees or task force involvement, etc.).
2. List any leadership positions in organized medicine that you have held.
3. Describe how your participation in the Leadership Development Academy might benefit you, your state, physician group, and/or local hospital.
4. Describe your interest in the Leadership Development Academy, including why you should be selected by the task force as a 2025-2026 participant.
To complete your application please e-mail the following items to Stephanie Posey at sposey@ohacep.org
- One letter of reference that speaks to the applicant's leadership performance or potential and commitment to continued development
- A Current CV
APPLICANT SUBMISSION INFORMATION
YES, if selected, I agree to participate in ALL designated segments of the Leadership Development Academy program
YES, I have discussed my application with and have the support of my department director
YES, my application is complete and my CV and a reference letter will be submitted to Ohio ACEP by April 25, 2025
Applications will be reviewed by the Ohio ACEP Leadership Development Task Force and chosen participants will be notified by mid-May.  
Please contact Executive Director, Holly Dorr at hdorr@ohacep.org with any questions.

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