Application for Admission
1.
Summary
Data:
Name:
______________________________ Applying
for class beginning________________
Last First
Middle
Date of Birth: ________________________ Sex:
___ Male ___ Female
Are you a
If you are a U.S. Citizen,
the following information is optional for statistical purposes:
___ African
Current mailing address:______________________________ Home telephone: _________________________
Work Telephone: _______________________ Fax: ___________________________________
GMAT Score (if applicable):____________________ E-mail: _________________________________
What is the highest academic degree you have
completed? Name and
address of your company/business unit/organization:
___________________________________________ ______________________________________
International business
exposure (check all that apply):
___ International Business Travel
___ Multinational Business Team ______________________________________
___ Foreign Expatriate Assignment
___ Multinational Business Responsibility
This
business/ unit/ organization is:
___ People
experience ___
Corporate headquarters
___ Project experience ___
An independent company
___
Public sector/ not for profit corporation
Current number of direct
reports: _________ employees Please
describe your company’s/ business unit’s/
organization’s business:
Current number of indirect reports: ________employees ____________________________________
Years of full-time work experience _________ years _____________________________________
Years of Manager experience
______________ years _____________________________________
Current title __________________________________ Check the range that describes the size of
your unit & organization
Please indicate your current annual salary including
bonus Business
Unit Size Range Overall Organization
and other money equivalents. ___ Fewer than 100 employees ____
___ 100-499 employees ____
_____________________________________ ___ 500-999 employees ____
___ 1,000 to 4,999 employees ____
___ More than 5,000 employees ____
2.
Organizational
References & Support:
A. Organizational
References:
Please provide the names and
addresses of the two individuals who you have asked to evaluate you. These
should be
your manager or others above you in your organization who can assess
your capabilities in the organizational environment
and can also speak for the
organization’s support of your participation. The first evaluator should be the
most senior of the
two. Owners/managers of independent
companies may seek the chairman or board members or might request the
evaluations
from their bank officer, attorney, or managers in customer or
supplier organizations with whom they have long-standing relationships.
First Evaluator: Second
Evaluator
_______________________________ _______________________________________
Name Name
_______________________________ ________________________________________
Title Title
_______________________________ ________________________________________
Address Address
_______________________________ ________________________________________
_______________________________ ________________________________________
_______________________________ ________________________________________
_______________________________ _______________________________________
Telephone Telephone
B. Organization
Support:
We encourage organizations to
fully support the managers they send to this program, financially as well as
with time.
Most organizations cover the
full cost of the program; others share the cost of the participants; and a few
students
pay the cost on their own.
Please explain how your participation will be financed by checking one
of the options below.
___ My
organization will pay the entire cost.
___ I will pay the entire
cost.
___ My
company and I will share the cost. I
will Pay _________ ($ or %); they will pay ___________ ($ or %)
3.
Educational
Data:
List the colleges and
universities you have attended and the diplomas or degrees conferred and
provide the dates
of attendance. Request the register of each college or university to
send a complete transcript of your record to
the Graduate
experience must be documented.
Name of Institution Location Dates of Attendance Degree & Year
Received
________________ _______________ ____________________ _____________________
________________ _______________ ____________________ _____________________
________________ _______________ ____________________ _____________________
________________ _______________ ____________________ _____________________
4.
Background
Data (please type B, C & D on one page):
A.
Please attach a
resume that begins with your most recent job or activity and covers the time
since your
undergraduate studies, including military service. Please present activities and descending
chronological
order and account for all periods of time.
B.
Described the organizational unit for which you are
responsible, and related to the total organization.
Discuss size, scope and economy of
responsibility. For what human
resources, budget, and capital
investment decisions are you responsible? To what position or positions do you report?
C.
If your work has involved you in international travel
or residence, please describe briefly.
D. Given the demands of the executive MBA, job responsibilities, and family needs, how have you involved
others in your decision to attend and how will you balance
these commitments?
5.
Special Work
Situations:
The curriculum of Old
Dominion University Executive MBA is designed around an ongoing management
relationship
with an established organization.
One major assignment involves a comprehensive strategic analysis of your
business.
In addition, participants must
carry out a large-scale, year-long corporate action project on behalf of their
organizations.
These projects require
the cooperation and resource support of the organization. The results from these projects are
intended
to be implemented and provide a significant benefit to the organization as well
as significant learning for the
candidate.
Your participation in the program depends on the opportunity to carry
out these job-related assignments
and projects.
They’re currently operating within a corporate environment where senior
management is a willing sponsor
of these two major
projects, you are all set.
If you are the owner/manager
of a very small company, an independent consultant, or are involved in
non-corporate work,
we would like you to consider and discuss the context or
organizational partners that can make it possible for you to carry
out the
applied assignments. Please attach a
separate piece of paper describing potential partners entitled
“ Special Work Situations” or contact the Executive MBA program director.
6.
Admission
Essays (please type each essay on separate pages):
Before writing, consider the
questions carefully in light of your particular circumstances and the
environment
in which your organization operates. Then prepare briefs responses to each of the
following four questions.
i.
Describe
contribution(s) you are making an organization that you consider to be valuable
and/or unique.
ii.
Describe
aspect(s) of your current jobs that you find to be most enjoyable and
rewarding.
iii.
What is the
published challenge that confronts you?
iv.
How can the MBA
help you be more effective for your current and future challenges?
To the best of my knowledge,
the information provided in this application is accurate.
Signature ______________________________________________ Date ___________________
Evaluation by Organizational Associate # 1
To the applicant: please fill in your name and deliver this evaluation form, along with
the confidential return envelope,
to your evaluator. Although only two of valuations are required,
you may certainly request others.
Name of applicant (print/type) ________________________________________________________________
To the evaluator: Please answer the questions below as candidly and specifically as
possible. Your insights about the
candidate will be an important part of our decision process. When you have completed the evaluation, place
it in the
envelope provided, seal and sign your name, and return it to the
candidate. Your comments will be
available only to
those involved in our admissions process and will be
destroyed when
they are no longer needed.
They will not be shared with the applicant.
Name of evaluator (print/type) _________________________________________________________________
Position/Title
____________________________________________
Telephone ___________
How long have you known the
applicant, and what is your working relationship?
Has your organization
identified this applicant as a high potential employee who is likely to take on
increasing
responsibilities? How would you rate this applicant’s performance
and potential within the organization?
What importance does the
attainment of an MBA degree play within your organization? Was the applicant’s
decision to undertake an executive MBA one that the organization suggested and
encouraged or one initiated by the applicant?
During the Old Dominion
University Executive MBA year, each participant undergoes extensive individual
assessment
and is required to set personal goals and take concrete actions to
strengthen areas of his or her professional and personal
life. What areas of
the applicant’s professional performance do you think could most benefit from such
individual attention?
Please compare the applicant with other managers in your organization
who are at the same level or higher.
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Top 10% Outstanding |
Top 25% Very Good |
Below 25% Representative |
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Intellectual ability |
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Initiative |
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Personal Integrity |
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Willingness to work hard |
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When the applicant has had
substantial responsibility for important tasks or projects, does she/he?
___ Meets expectations ___ Often exceeds Expectations ___ Almost always exceeds expectations
Which one of the following statements is most applicable to the candidate
over the next two years?
___ Almost certainly will be in position
of substantially greater management responsibility than his/her
present
position.
___ Has a good chance of being in a
position of substantially greater management responsibility than
his/her
present position.
___ Will gain valuable education and experience which will put
him/her in position for promotion and
greater responsibility at some later
date.
___ The successful completion of this
degree will greatly enhance his/her performance in current job.
This is an accelerated
program that will place heavy demands on the participants. Their likelihood of
success will
be improved by a stable and supportive family life, a flexible
work environment, social and professional maturity,
and a willingness to work
hard. Please comment on any of these aspects you think may pose an added
challenge
to the applicant.
continues to perform in his or her full-time career. Have the
candidate and her/his superiors in the organizations
discussed the program, and
is the organization willing to support the candidate’s attendance at all
residence periods
as well as the work that is to be completed in connection
with the organization?
We encourage organizations to
fully support the managers they send to this program both financially as well
as
with time. Many organizations pay the full cost of the program; others share
the cost with participants.
Please explain how this applicant will be financed.
___ Our organization will pay the entire cost
___ The applicant will pay the entire cost
___ We will share the cost. The applicant will pay _________($ or %) The
organization will pay _________ ($ or %)
Evaluator’s Signature ____________________________________ Date: ________________