2025 Iowa Total Care Executive Health Care Leadership Application Form

2025 Executive Health Care Leadership Institute Application

This form is an application for individuals from IHCA member facilities interested in joining the 2025-2026 IHCA Executive Health Care Leadership Institute. This program is specially designed for leaders who work in long-term care and includes the leadership fundamentals necessary to lead others and the specific technical skills in demand in long-term care settings. Applications are due by July 31.

Applicant Information

Applicant Name(Required)

First Last

Applicant Address(Required)

Street Address Address Line 2 City State ZIP Code

Applicant Phone(Required)

Applicant Personal Email(Required)

Applicant Work Email

Employer Information

Is your employer a member of the Iowa Health Care Association?(Required)

Yes

Employer Company Name(Required)

Employer Address

Street Address Address Line 2 City State ZIP Code

Administrator/Director's Name(Required)

First Last

Administrator/Director's Phone(Required)

Administrator/Director's Email(Required)

Applicant's Job Title(Required)

Number of Years Applicant Has Worked in Long-Term Care(Required)

Month/Year of Hire at Current Employer(Required)

Required Documents

Essay(Required)

Max. file size: 50 MB.

Compose and upload an essay of no more than 500 words. It must be your own work and include discussion on the following: 1) The reason you selected long-term care (nursing facility, continuing care retirement community, assisted living facility or home health agency) as your career field and your work history in long-term care, including any supervisory experience or future anticipated supervisory duties. Please include the number of direct reports you have directly supervised and the scope of your supervisory responsibility. 2) Your career goals specific to long-term care (i.e., nursing facility, continuing care retirement community, assisted living facility or home health agency). 3) How you plan to apply what you learn from the IHCA Executive Health Care Leadership Institute to your work in long-term care. Describe how this course will improve or enhance your current supervisory skills and outcomes.

Letter of Recommendation(Required)

Max. file size: 50 MB.

Upload one letter of recommendation from your administrator/director or manager. Please ask them to include your name, their name, organization name, telephone and email address in the letter. Also in the letter, ask them to describe why they believe you would be a worthy recipient of an IHCA Foundation scholarship. Please limit letters to 200 words or less.

Applicant Resume

Max. file size: 50 MB.

Please upload a copy of your most recent resume.

Terms of Agreement and Conditions

Terms of Agreement(Required)

I certify with my initials below that I meet all the eligibility requirements for the program for which I am applying. I certify that all the information contained herein is true and correct.

CAPTCHA