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Program Enrollment

Which PTL cycle are you applying for?

Summer 2026

Personal Information

Salutation

First Name

Last Name

Middle Name or Initial(s)

Nickname

Job Title

Occupation

Are you a:

Federal Government EmployeeState or Local Government Employee

Department or Agency

If your agency is not listed, type and select “Other”.

Other Department or Agency

Avoid acronyms

Subcomponent

Avoid acronyms

Office or Work Unit

Avoid acronyms

State

County or Municipality

Agency Name

Do not include the State or Municipality in this field.

Full State/ Local Agency Name

Please double check above that the full name of the agency is correct.

Work Phone

Mobile Phone

Home Phone

Preferred Phone Number

Work Email

Personal Email

Preferred Email Address

Address Type

Street

City

State

Zip Code

Country

Address Type

Street

City

State

Zip Code

Country

Professional Experience and Objectives

Total years of government service

GS Level or Equivalent

Are you a leader of:

Emerging Leader (Team or work group member/ aspiring supervisor/ developing technical expert)Leader of Teams or Projects (Team or work group leader/ project leader/ new supervisor/ technical expert)Leader of Organizations (Executive and enterprise leader/ cross-sector, interagency and intra-agency convener/ organizational driver of change)Leader of Leaders (Office, division or large-team leader/ program portfolio leader/ mid-level supervisor/ technical leader in the field)None of the above

Number of employees you supervise

What are the top leadership development goals you are trying to pursue? Limit 300 words.

Supervisor Information

Salutation

Supervisor First Name

Supervisor Last Name

Supervisor Job Title

Supervisor Phone

Supervisor Email

Street

City

State

Zip Code

Country

Supervisor Endorsement Form

Upload your signed supervisor endorsement form.

Tuition Payment Information

Please make all checks payable to Partnership for Public Service, Inc., and remit to company address. If you wish to pay by credit card or wire transfer, or for any other questions, please call the Partnership Finance Department at 202-996-5288 or email invoice@ourpublicservice.org.

Intended form of payment, if known

ACH Wire TransferCheckPurchase OrderCredit Card

Purchase Order Number (PO#)

Please attach any payment document (e.g., SF182) below:

Check this box if you do not currently know your agency’s Payment Point of Contact information

Agency Payment Point of Contact (POC) Information

Payment POC name:

Payment POC email address:

Payment POC phone number:

Supplemental Information

How did you learn about this training program?

Once accepted into this program, your non-refundable tuition payment will be required before the program start date. If you can no longer attend, you may defer your program registration for up to one year. For any questions or concerns about making payment before the program start date, please contact our team at invoice@ourpublicservice.org.

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