Compassionate Leadership Coaching ProgrammeApplication Form: January 2020 CohortApplication DetailsName of Application Holder:Organisation:

Position:

Email:

Telephone:

Name of Executive Organisational / System sponsor for programme:Position:

Please tell us why you are applying for the Compassionate Coaching programme and why this would currently benefit your role?

What impact are you hoping to see at individual and organisational level?

Cohort Dates:

Programme Delivery Date and Time

Electronic pre-programme metrics and questionnaire (maximum 30

minutes)

Sent w/c 13th January 2020 – completed and returned by 24th

January 2020

Introduction to Programme Webinar (40 minutes) Link sent on Monday 13th January

2020 – watched by 28th January

Online Group Coaching Session One(1 Hour) Tuesday 28th January 2020

10.30-11.30am

Online Group Coaching Session Two(1 Hour) Wednesday 12th February 2020

12.45-1.45pm

Online Group Coaching Session Three (1 Hour) Thursday 27th February 2020

2.00-3.00pm

Online Group Coaching Session Four(1 Hour) Thursday 12th March 2020

12.45-1.45pm

Electronic post-programme metrics and evaluation (maximum 30

minutes)

Sent on 12th March 2020 – completed and returned by 19th

March 2020

Post-Programme Online Group Workshop(1.5 Hours)

Friday 3rd April 202010.30am-12.00pm

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Online Meeting aspect of The Compassionate Leadership Coaching Programme:

All aspects of the Programme are conducted electronically to allow participants to be present regardless of geographical location. As this is a critical aspect of the programme, each participant is asked to agree to the following before accepting a place on the programme:

IT requirements in place– GOTO Meeting can be enabled, PC/Laptop/Tablet/Smartphone with good WIFI access assured with webcam, microphone and Windows Media Player in working order – access to landline telephone to dial into the coaching session (as back up) accessible if internet/mobile signal temporarily unavailable. If your organisation’s hardware doesn’t allow access, then it is fine to use your own hardware ie: laptop, PC, Smart phone or ipad to access the online sessions.

Accurate email address provided by participants confirming full access to attachments and links.

Private meeting/office space available for coaching sessions and webinar access.

You can check if your hardware can access GOTO Meeting by following this link:https://link.gotomeeting.com/system-check

It is also requested that all participants give their agreement to complete pre and post metrics as requested, adhere to the schedule of the programme (other than in exceptional circumstances), complete the evaluation at the conclusion within the seven-day deadline and attend the post programme workshop on the agreed date.

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Participant Signatory and Commitment to Availability of Programme dates above (on behalf of Organisation / System)

………………………………….. Name

………………………………….. Job Title

………………………………….. …….......……… Signature Date

Executive Authorised Signatory (on behalf of Organisation / System)

………………………………….. Name

………………………………….. Job Title

………………………………….. …….......……… Signature Date

Please send the completed form by email to nwla.info@nhs.net

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