Today's Date * Employee ID* Full Name * Your Title * Email Address * Education * No High School Some High School High School Graduate/GED Some College Associate Degree (2 YR) Bachelor's Degree (4 YR) Some Graduate School Post-Graduate School Telephone Number * Pay grade * 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 Length of Employment * Work Address * Approving Manager * Challenges* (As a manager, supervisor or promotional candidate, what types of challenges do you face most often?) Did your manager approve your enrollment? * Yes No Manager's Job Title * Manager's Telephone Number * Department * ARA 65 Administration/ Regulatory Affairs CNL 55 City Council CSC 75 City Secretary CTR 60 City Controller DON 11 Department of Neighborhoods FIN 64 Finance FMD 67 Fleet Management Department GSD 25 General Services Department HAS 28 Houston Aviation Services HCD 32 Housing & Communirt Development HEC 15 Houston Emergency Center HFD 12 Houston Fire Department HHS 38 Health and Human Services HPD 10 Houston Police Department HPL 34 Houston Public Library HR 80 Human Resources IT 68 Information Technology LGL 90 Legal MCD 16 Municipal Courts Department MYR 50 Mayor's Office OBO 51 Office of Business Opportunity PD 70 Planning and Development PR 70 Parks and Recreation PWE 20 Public Works and Engineering SWD 21 Solid Waste Department Division and/or Section * Cost Center Number * Fund Number * Direct Reports * (How many full-time city employees report directly to you? If you do not currently manage or supervise any city employees, please enter zero.) Indirect Reports * (How many full-time city employees report indirectly to you (i.e., report to someone who reports to you)? If you do not currently manage or supervise any city employees, please enter zero.) Promotion Candidate * (Are you currently being considered for a promotion within the next six months?) Yes No Current Manager Duration * (How many months have you maintained your current management or supervisory position? If you are not currently a manager or supervisor, please enter zero.) HEAR * (Do you administer the HEAR process for any of your employees.) Yes No Type of Work * (Briefly describe the type of work performed by the employees who report to you.) CAPS Expectations * (What do you expect to gain from your experience in CAPS?) Personal Differentiation * (Please provide other qualifications (e.g., certifications, experience, etc.) that you feel would make you a good candidate for the CAPS program)