Save & Return

Use an account to return to saved work.

Leaders Plus Changemaker Fellowship Programme Application Form

Thank you for your interest in the Leaders Plus NHS Changemaker Fellowship Programme.

We encourage you to apply as soon as possible to our NHS Changemaker programme as places are limted. Please be advised the last date you can submit an application is midnight on Tuesday 27th June 2023.

If you have any questions then please email us.

Best of luck with your application!

The Leaders Plus Team

If you would like to save and return to your application at any point then do please use this link and create an account.

Applying for the Leaders Plus NHS Changemaker Fellowship

This innovative pilot programme is open only to graduates of the NHS Leaders Plus Fellowship Programme and will enable you to initiate a change project in your organisation around supporting parents. You will develop change management and leadership skills. Before you start the application we want to make sure you meet the requirements for the Fellowship. Please confirm the following statements:

*

I am a graduate of the NHS Leaders Plus Fellowship

I will be able to initiate a change project around supporting parents in my organisation

About You

First Name *

Surname *

Email *

Contact Number *

Which of the following most accurately describes you? *

Female

Male

Prefer not to say

Other: Other:

What is your ethnic group? We use this information for reporting purposes only and will not be using your answers as part of the selection process for a place on the Leaders Plus Programme *

Employment

Who is your employer? *

Current or most recent role *

About your Change Project

This programme will enable you to initiate a change project in your organisation around supporting parents. If you have identified a project you would like to inititate please briefly describe the project below. It is okay if you haven't yet identified a project.

Funding

Please indicate how you plan to fund the Fellowship. You do not need to have funding agreed with your employer to select 'Employer Funding.'

How are you funding the Fellowship? *

Employer funded

Self funding

Have you had your funding confirmed from your employer? This is for our information only and will not impact your application. It is fine not to have funding agreed at this point. If you would like help with asking your employer for funding please book a call with Jo Donoris here. *

Yes

No

Please provide the name of the person the invoice should be sent to. If you do not know this information at this point please put your own details. *

Please provide their email address *

Please provide email address for invoicing *

Payment Schedule *

Pay in full (£1390 + VAT by 15th September 2023)

Pay in 2 instalments (£695 + VAT by 15th September 2023 and £695 + VAT by 15th November 2023)

Privacy Statement

We are careful with the information you give us. Please see our privacy policy. You can withdraw your permission at any time. Please email us if you would like to withdraw permission.

I am happy for you to store my data in line with the privacy policy and contact me in relation to the Fellowship *

Yes

No

Would you like to sign up to our newsletter? You can unsubscribe anytime and we never spam! *

Yes

No