2025 Emerging Leaders Nomination Form

2025 Emerging Leaders Nomination Form

We are now accepting nominations for the 2025 APHSA Emerging Leader Program. Please consider nominating an up-and-coming leader within your organization for this opportunity. Nominations will close on Friday, June 6, 2025.

Each year, the cohort class is comprised of 30 nominated junior and mid-level professionals from state and local government and the private sector who are on track for leadership roles in the next 3-5 years of their career. In addition to attending the conference, Emerging Leaders engage in a tailored conference within a conference experience uniquely crafted to their leadership development, including:

Closed sessions with Human Services Leaders
Private networking receptions
Curated sessions with industry leaders
Opportunity to showcase their leadership journey
Special recognition at the conference

Nominee Criteria

Nominees should meet all or most of the following criteria:

The nominee is interested in pursuing professional growth and leadership development through this experience
Demonstrated high performance over a sustained period
Seen as a future business or technology leader within the organization
Likely to assume a leadership role within the next 3-5 years
5-10 years of experience preferred*

*5-10 years in a junior/mid-level position on track to a leadership role.

Accepted nominees will be notified by June 23, 2025.

For complete details on the Emerging Leaders program and application, click here.

Nominator Information

Please provide us with your information.

First Name*

Last Name*

Title*

Agency/Organization*

Please spell out the full agency/organization name.

Phone*

Phone

Email*

Nominee Information

Complete the following about the individual you are nominating as an Emerging Leader.

First Name*

Last Name*

Title*

Agency/Organization*

Please spell out the full agency/organization name.

Address*

City*

State*

Zip Code*

Phone*

Phone

Email*

LinkedIn Profile

Which Sector Does the Nominee Represent?*

Public Sector: State Agency

Public Sector: Local or Municipality Agency

Private Sector: Industry or Non-Profit

What county does the nominee work for?*

Has the nominee attended ISM before?*

Yes

About the Nominee

Please provide concise answers/comments to the following questions to assist in the selection process.

What are the nominee’s current responsibilities?*

Please include whether the nominee has management/supervisory responsibilities.

What is the nominee's area(s) of expertise?*

Select up to three.

Select

How do you know the nominee?*

Do you have direct supervision of the nominee?

How many years of HHS experience and/or IT experience does the nominee have?*

Describe characteristics this nominee displays to qualify them as an Emerging Leader.*

Provide examples of how the nominee has collaborated on or led projects within the organization or community to demonstrate their commitment to the human services sector, especially as it relates to modernizing technology and/or business processes.*

Provide insight on how the nominee actively communicates with peers and supervisors to help encourage team participation/interaction on projects.*

Are there additional insights the committee should consider about the nominee when reviewing the nomination?

Fellowship Opportunity

APHSA has limited travel funds available for ISM Fellowships. State and local government employees selected for the Emerging Leader Program have the opportunity to apply for ISM Fellowships. ISM Fellowships offer travel assistance for state and local government individuals to attend the ISM Education Conference & Expo. These ISM Fellowships are intended to help ensure that the Emerging Leader Program is accessible to nominated and selected individuals that would not be able to participate due to budget restrictions within their agency of employment.

Is the nominee applying for an ISM Fellowship?*

Yes

Select which level of assistance is needed:*

Hotel up to three (3) nights Only

Travel (up to $500 stipend for airfare, train, or mileage)

Registration Only

Registration and Hotel up to three (3) nights Only

Registration and Travel (up to $500 stipend for airfare, train, or mileage)

What travel assistance is being requested?*

Airfare

Train

Mileage

If air/train travel is approved for a fellowship, APHSA will provide a stipend up to $500 for airfare or train travel. Any overage will be the responsibility of the traveler and/or their employer. If mileage is requested, it will be reimbursed at the standard IRS rate at the time of the conference.

I understand, if air/train travel is approved for a fellowship, APHSA will provide a stipend up to $500 for airfare or train travel. Any overage will be the responsibility of the traveler and/or their employer.*

Billing Contact (Procurement Officer)

Provide the billing contact information for your agency/organization. This is the invidudal responsible for paying invoices for the agency.

Billing Contact Name*

Billing Contact Address*

Billing Contact Phone Number*

Phone

Billing Contact Email*

Participation Guidelines

If selected, the nominee must fully participate in ALL scheduled Emerging Leaders activities including ALL pre-conference virtual meetings and ALL Emerging Leaders Conference Sessions.

If selected, the nominee understands that they must fully participate in ALL scheduled Emerging Leaders activities including ALL pre-conference virtual meetings and ALL Emerging Leaders Conference Sessions.*

Acknowledgements and Agreements - Public Sector

Please review the following acknowledgements which demonstrate your commitment to support the nominee as a participant in the APHSA Emerging Leader Program.

If selected, the nominee understands that they must fully participate in ALL scheduled Emerging Leaders activities including ALL pre-conference virtual meetings and ALL Emerging Leaders Conference Sessions.

If selected, I understand this will require in-person attendance by the nominee at the 2025 ISM Education Conference & Expo September 14-17, 2025 in Reno, NV.

If accepted and requested, APHSA may provide conference registration and/or lodging for three (3) nights. There is a stipend for airfare/train travel (not to exceed $500) for the nominee. I understand I should only request travel assistance for the nominee to attend if my organization cannot cover costs.

The nominee is aware that they have been nominated for this program.

If selected, I understand this is a non-transferable nomination should the nominee not be able to participate in the full program.

If selected, the nominee understands that they are expected to attend State and Local Forum sessions during the ISM Education Conference & Expo.

Travel Acknowledgements

I understand that a fellowship, if requested and approved, may cover up to a 3-night stay (room & tax only) at the conference hotel, registration, and/or roundtrip travel (by air or train).

I understand, if air/train travel is approved for a fellowship, APHSA will provide a stipend up to $500 for airfare or train travel. Any overage will be the responsibility of the traveler and/or their employer.

I understand the nominee is responsible for registering themselves with a registration discount code provided by APHSA.

I understand no meals, outside of the conference functions, or ancillary expenses (bag fees, mileage, parking, etc.) will be covered during travel or at the conference. These are the responsibility of the traveler.

I understand NO miscellaneous travel expenses will be covered by the fellowship offered for the Emerging Leaders Program and are the responsibility of the traveler.

I understand, as part of receiving any travel or registration assistance, I will be expected to attend the State and Local Forum and participate in sessions through the end of the conference.

I understand that any exceptions to these guidelines must be made in writing to APHSA for review, two weeks prior to the conference.

Acknowledgements and Agreements - Private Sector

Please review the following acknowledgements which demonstrate your commitment to support the nominee as a participant in the APHSA Emerging Leader Program.

If selected, the nominee understands that they must fully participate in ALL scheduled Emerging Leaders activities including ALL pre-conference virtual meetings and ALL Emerging Leaders Conference Sessions.

If selected, I understand this will require in-person attendance by the nominee at the 2025 ISM Education Conference & Expo September 14-17, 2025 in Reno, NV.

If accepted, I understand my organization is responsible for registration, airfare, and lodging for the nominee to attend the conference.

The nominee is aware that they have been nominated for this program.

If selected, I understand this is a non-transferable nomination should the nominee not be able to participate in the full program.

Travel Acknowledgements

I understand, if selected, my organization is responsible for conference registration, airfare and lodging to attend the conference.

I understand that my organization may not use one of their complimentary sponsor registrations for my registration.

I understand that any exceptions to these guidelines must be made in writing to APHSA for review.

By electronic submission, I attest I have agreed to all the APHSA Emerging Leaders Acknowledgements.*

Send me a copy of my responses

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