Police Leadership Program

Nomination and Reference Form

Before completing this application form, please prepare and have available electronically the following documents in Word or PDF format:

Candidate's Resume
Letter of Reference

You will be given instructions in the latter portion of the application for attaching these documents.

* Required Fields

Nominating Authority Information

Salutation *
First Name *
Middle Name
Last Name *
Preferred Name
Title/Rank *
Address 1 *
Address 2
City *
Province/State *
Postal/Zip Code *
Country *
Phone Number	()-
Fax Number	()-
Email *

Candidate Information

Salutation *
First Name *
Middle Name
Last Name *
Preferred Name

Employment Information

Title/Rank *
Employer
Department
Address 1 *
Address 2
City *
Province/State *
Postal/Zip Code *
Country *
Phone	()-
Extension
Fax	()-
Email *

Home Information

Address 1
Address 2
City
Province/State
Postal/Zip Code
Country
Phone	()-
Email

Accommodation Requirements

Accommodations At Nearby Hotel Required
Accommodations Not Required
Undecided

Required Documents

Please submit a current resume and reference letter as part of this application. (File must be in Word, PDF or TIF format.)
Resume *
Reference Letter *

Additional Questions

How did you hear about this program? *

From a program graduate
From my employer
Advertisement, where:
Correspondence from Rotman School, how:
From a Professional Association, which one:
Other:

Rotman Fundraising

Would you like to get involved and learn more about the Rotman's expansion and the $200-million campaign?

Yes No

Deposit Payment

Credit Card Name	If you are using a credit card to pay on the subsequent online payment page please provide the name on credit card.
Submit and proceed to complete your online deposit payment of $5250. You will be redirected to our secure online payment provider eRegisterNow. Your credit card information will not be saved on Rotman Servers. Program deposit is required at time of application in order to reserve a seat in the program once the Admissions Committee has reviewed your application. Applications will only be reviewed when deposit is received. I have read and accept the terms and conditions
Click Submit to proceed to payment options.