Cohort 10 Application Form
Leadership for Empowered Communities and Personalised Care -
Cohort 10 Application Form

This application form helps us check your suitability for the Leadership for Empowered Communities and Personalised Care (LECPC) Programme.

Please complete all sections below and return the completed application form to Lynsey Oates at
as soon as possible but before 5pm Friday 16th December 2022.

Please note that the following criteria will be used for selection:
• alignment of personal objectives for the programme to programme objectives
• demonstration of commitment to personal leadership development
• demonstration of commitment to meeting the challenge of making personalised care a reality
• freedom to act and implement learning from the programme in current role
• ability to attend all the face-to-face and virtual workshop dates (see section 3 for the list)
• acceptance of the cancellation policy (see section 3 for details)

Selection will be carried out by a virtual panel. We will contact you to advise if you have been successfully accepted onto the programme as soon as possible after the closing date (above).

Please answer all the questions below in typed format. Feel free to expand the form to suit your answers.
This is your form description. Click here to edit.

    Please tell us who you are
  • NB If your application is successful, the above contact information will be shared with your programme colleagues, facilitators and with programme partners, to enable invitations to related events.

    Job Role Information and Supporting Information

    1. Dates
    I confirm that I would like to apply for the Leadership for Empowered Communities and Personalised Care Programme and that I am able to attend all the face to face and virtual modules (webinars) as listed below.

    Face to Face – All of these sessions will take place between 9.00 – 5.00pm:
    • Thursday 26th January, London
    • Wednesday 8th & Thursday 9th March, Loughborough
    • Thursday 27th April, London
    • Wednesday 7th June, London
    • Thursday 6th July, London

    There will also be virtual meet and greets and webinars between the face to face sessions.

    2. Fees and cancellation
    I agree to the terms and conditions and the penalty fees for non-attendance of any part of the programme as detailed below.

    Programme fees – All fees must be paid in full before the start of the programme.
    Fees cover refreshments, meals and programme materials but do not include travel to or from the programme venues, or accommodation if you choose to travel overnight.

    Cancellation and transfer fees – All nominations must relate to the individual applicant. Once your place is confirmed to you, the following terms and conditions apply:

    • More than 30 days’ notice – no charge will apply
    • Less than 30 days’ notice – a cancellation charge of 50% of the programme cost will be applied
    • No show/not attendance – a penalty charge of £2,000 plus VAT will be applied