Employee Name:

Completed by: Date:

Current Position: Months in Current Position:

Past Position: Years with MnSCU:

1. Employee’s most recent performance appraisal has been considered. ☐Yes☐No2. Employee’s CV or Resume is attached (for submission to selection committee) ☐Yes☐No3. Employee Potential Assessment (see page two): ☐High (8-10) ☐Medium (4-7) ☐Low (0-3)Evaluate how employee demonstrates leadership competencies by checking: Dominant Strength, Acceptable, or Area of Weakness. See leadership competency definitions to inform your assessment.

Competency DominantStrength

Acceptable Areas to Manage

Comments

LEADER OF SELF1. Understands Self and

Others☐ ☐ ☐

2. Acts with Integrity ☐ ☐ ☐LEADER AS RELATIONSHIP BUILDER3. Values Diversity ☐ ☐ ☐4. Communicates

Effectively☐ ☐ ☐

5. Builds Trust ☐ ☐ ☐LEADER AS MANAGER6. Builds Customer Service

Orientation☐ ☐ ☐

7. Builds Organizational Talent

☐ ☐ ☐

8. Demonstrates Good Stewardship

☐ ☐ ☐

LEADER AS INNOVATOR9. Articulates

Mission/Vision☐ ☐ ☐

10.Builds Organizational Capacity

☐ ☐ ☐

11.Demonstrates Effective Decision Making

☐ ☐ ☐

Add number of boxes checked for each column

Multiply by 2 Multiply by 1 Multiply by 0Multiply each column score by number indicated and addthree scores across for total

+ + = TOTAL:

4. Leadership Competency Score (from table above) ☐High (15-22) ☐Medium (9-14) ☐Low (0-8)

Talent Management, HR Division – Revised September 2013The Minnesota State Colleges and Universities system is an Equal Opportunity employer and educator.

Acceleration Pool Nomination Form

Scorecard for Assessing Potential 1

Answer yes or no to the following questions.

1. Could the employee perform at a higher level, in a different position or take on increased responsibilities within the next year (consider the person’s ability only, not whether there is a position available to support this growth)?

2. Could the employee perform at a higher level, in a different position, or take on increased responsibilities within the next three years (consider the person’s ability only, not whether there is a position available to support this growth)?

3. Can you envision this employee performing two levels above his or her current position in the next five to six years?

4. Is the organization likely to value growth of the skills and competencies of this employee over the next several years?

5. Could the employee learn the additional skills and competencies he or she needs to be able to perform at a higher or different level?

6. Does the employee demonstrate leadership ability—by showing initiative and vision, delivering on promised results, communicating effectively, and taking appropriate risks?

7. Does the employee demonstrate an ability to comfortably interact with people at a higher level or in different areas?

8. Does the employee demonstrate comfort with a broader organizational perspective than his or her job currently requires?

9. Does the employee demonstrate motivation to move into a senior leadership role?

10. Does the employee welcome opportunities for learning and development?

To evaluate this employee’s potential, calculate the total number of “yes” responses and use the following scoring. Transfer your score to the front page, number 2

TOTAL “YES” RESPONSES: ________________

8-10 = High; 4-7 = Medium; 0-3 = Low

1 Adapted from Harvard ManageMentor at http://www.harvardmanagementor.com/ and Great Leadership, Dan McCarthy Consulting at http://www.greatleadershipbydan.com/

Talent Management, HR Division – Revised September 2013 PLEASE NOTE: THIS FORM CONTAINS PESRONAL DATAThe Minnesota State Colleges and Universities system is an Equal Opportunity employer and educator.

CANDIDATE ENDORSEMENT

1. Describe why you have nominated this individual. You may include key examples of strengths, distinctive skills and abilities, and retention issues. (Please limit your comments to 200 words or less.)

READINESS/EXPERIENTIAL DEVELOPMENT NEEDS

2. What experiential gaps are preventing this individual from successfully competing in a presidential search today?

3. Considering this individual’s performance and potential, they could be ready to successfully compete for a presidential position if given the right experiential development opportunities in:

☐1 year ☐2-3 years ☐4-5 years

Talent Management, HR Division – Revised September 2013 PLEASE NOTE: THIS FORM CONTAINS PESRONAL DATAThe Minnesota State Colleges and Universities system is an Equal Opportunity employer and educator.