IT Learning Services Pre-course Survey Questionnaire
619125-161925Leading the Frontline Participant Information 00Leading the Frontline Participant Information Please complete and e-mail to Rich Martini at Richard.Martini@ucsf.edu Leading the Frontline Participant CommitmentsPlease Read Carefully Those attending the Series must be able to meet all the following commitments:Complete an assessment prior to the beginning of the series.Attend every session.? Complete between-session assignments requiring an average of 2 hours every two weeks.? Develop and implement a development plan. Complete the following informationNamePhone #extDept. NameYour TitleYour Manager’ NameEnrollment Fee of $300 will be recovered from the indicated cost center. Medical Center or Campus Cost of Accounting Chart String. Please see your Manager for this information.EX: 4321-705166-1111111-42-16-ABC123 Fund Code (4 digits)Dept. ID / Cost Center (6 digits)Project Code (7 digits)Activity Period (2 digits)Function Code (2 digits or enter Zeros)FlexField (optional; up to 6 alphanumerical digits)Are you a Medical Center or Campus employee? FORMCHECKBOX Medical Center FORMCHECKBOX CampusWhat type of role did you have prior to becoming a supervisor/manager?Patient Care ________Administrative _________Other – describe _________What is the number of people do you supervise? Patient Care ________Administrative _________Other – describe _________What is the number of direct reports that you conduct performance appraisals for? _________Your experience: please enter the number of months or years for each question.In current positionYears__ Months__ As a supervisorYears__ Months__Years at UCSFYears__ Months__How would you define your role? What specific supervisory/leadership challenges are you currently facing? Strengths?What are your objectives for participating in the Leading the Frontline Series?How did you hear about Leading the Frontline series?Can you commit to all requirements listed above? (Please check your calendar against session schedule) FORMCHECKBOX Yes FORMCHECKBOX No (please explain)Signature and Date (typed name is acceptable) ................
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