Applicant Information Page 1 of5 Di CAI. UN RS ITY State University of New York State Employment Application We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran status or disability. Upstate Medical University is committed to assisting all members of the Upstate Community and to provide for their safety and security. A copy of Upstate Medical University's Annual Security Report is available on our web site at It can also be obtained from the Director of Public Safety at Upstate Medical University, 750 East Adams Street, Syracuse, New York 13210 or by calling (315) 464-4134. This report includes statistics for the previous three (3) years concerning reported crimes that occurred on campus; in certain off-campus buildings or property owned or controlled by Upstate Medical University; and on public property within or immediately adjacent to and accessible from, the campus. The report also includes institutional policies concerning campus security, such as policies concerning alcohol and drug use, crime prevention, the reporting of crime. sexual assault, and other matters. Requisition Number: 0458 55 Job Title: Vice President and Chief of Staff Personal information ILast Name: First Name: Middle Initial: Suffix: Garcia Sergio A Present Address Address Line 2: City: State: Zip Code: Country: NY United States Home Telephone: Alternate Telephone:: Email: Additional Information Are you legally restricted or prohibited from being employed by Upstate Medical University? No Are you a current employee of Upstate Medical University? No Do you have any relatives employed with Upstate Medical University? No If yes, list name and department: Have you ever been employed by any NYS Government Agency, including Upstate Medical University? No If yes, list job titles held, departments and dates of employment: Have you ever been terminated from employment or asked to resign in lieu of termination? please explain it NO, enter NA: No NA Are you 18 years of age or over? Do you currently use illegal drugs? Yes No Except for minor traffic violations, have you ever been convicted of an offense of law (is, criminal, Have you ever been excluded, prevented, barred, sanctioned or Applicant Information misdemeanor, or felony)? (Convictions shall include it yes. please include date. location of court. type of violation. misdemeanor or sentence imposed by a court of law. A conviction Will felony conviction for each offense a plea. verdict. or ?nding of guilt, regardless of the not automatically bar employment consideration in accordance with NYS Correction Law Article 23-A. Section 754.) No Position Information IAvailability: Page 2 of5 suspended from participating in Medicare. Medicaid or any Federal. State or private health care program? No Full-Time Per Diem .Part-Time (hours per week) noes: Student 1st (days) Monday-Friday 2nd (evenings) 12-Hour Shift 3rd (nights) Weekends Only Rotating (specify shift) anyou work weeks? I Yes Education Wage/Salary dsired: Name of School: Type of school: Did you receive a Dipioma/Degree?? If yes. please specify Major and Minor: diploma/degree received: case Western CollegeIUniversity Reserve University Cleveland. OH Yes MS Organizational DeveIOpment and Change Universidad de las College/University Americas, Puebla Puebla. NA Yes BS international Law Burbank Senior High School Burbank, CA High School Yes High School No Response No Response No Response Work Experience Position: Employer Name: Dates Employed: Departmen. division. or section: Supervisor's Name: Supervisor Title: Supervisor Telephone Number: Major Duties: Reason for Leaving: ii Full Time or Part Tie: May we contact this employer? Number of hours werked per week; Applicant Information Page 3 of 5 [Full Time [50 I Employer Name: Position: Dates Employed: Northeast Ohio Medical University Chief of Staff and VP DEI From: 11-01-2012 4209 State Route 44 . Rootstown. OH 44202 01,29] 2?16 Department. division. or section: Supervisor's Name: Supervisor Title: Supervisor Telephone Number: Office of the President President Major Duties: Provided leadership in maximizing the use and impact of the President's time and leadership on activities of strategic importance, including overseeing the establishment of the Office of Diversity, Equity and Inclusion. Reason for Leaving: May we contact this employer? Recruited to healthoare delivery system Yes Full Time or Part Time: Number of hours worked per week: Full Time 50 Dates Employed: From: 10-01-2011 To: 10/30/2012 Employer Name: U.S. Department of State 1225 Street Washington, DC 99999 Department. division, or section: Supervisor's Name: Supervisor Title: Supervisor Telephone Number: ern Reason for Leaving: May we contact this employer? Last deployment for US government Yes Full Time or Part Time: Number of hours worked per week: Full Time 55 Employer Name: Position: Dates Employed: U.S. Department of Defense From; 04.01-2010 Doral . Doral, FL 55555 To. 09/01/2011 Department. division, or section: Supervisor's Name: Supervisor Title: Supervisor Telephone Number: Major Duties: NIA Reason for Leaving: May we contact this employer? No Full Time or Part Time: Number of hours worked per Week: Full Time 60 Employer Name: Position: Dates Employed: International Republican institute Country Director From; 07-01.2007 1225 Street . Washiongton. DC 20005 To' 12,31,2009 Department: division. or section: Supervisor's Name: Supervisor Title: Supervisor Telephone Number: Latin American and Regional Director Caribbean Division Major Duties: Applicant Information Page 4 of 5 Managed and operated lRl's second largest office in Latin America with an effective $2.1 million annual budget. Directed all financial planning and expenditures, including independent auditing measures for each program and sub-grantee. Reason for Leaving: May we contact this employer? Returned to government service Yes Full Time or Part Time: Number of hours worked per week: Full Time 50 Employer Name: Position: Dates Employed: U.S. Department of State Chief of Staff/Senior Policy Advisor From; 03-01-2004 Street . Washington, DC 20005 07/15/2007 Department division. or section: Supervisor?s Name: Supervisor Title: Supervisor Telephone Number: Major Duties: Managed and advised front office leadership team, providing overall management and evaluation of Bureau's global operations and programs totaling million. Aided Secretary of State to promote and ensure inter- agency coordination on policy and programming, and further coordinated with congressional leaders and staff. Reason for Leaving: May we contact this employer? Overseas opportunity Yes Full Time or Part Time: Number of hours worked per week: Full Time 50 Professional References Reference Name Email Address: Phone Number: How do you know this reference?: Former Supervisor Former Supervisor Colleague Licensure (if applicable to position) Has any action been taken against your If yes. please explain: license/registration? No Supplemental Questions How did you learn about this open position? Upstate's Web site You may specify here (if applicable): NA Do you have an advanced Degree in Health Care. Communications. Public Relations. Public Affairs. Public Administration, Management. or related field of study and a minimum of 7 years of significant administrative experience in an academic medical center. public relations/public affairs. including responsibility for the direction of organizational programs and staff? Yes Applicant Information Page 5 of? 5 it is the objective of Upstate Medical University to provide a safe and healthy campus environment for employees. students. volunteers. patients. and visitors. To further this goal. smoking and tobacco use of any kind is prohibited in ail Upstate buildings. offices. parking and maintenance garages, associated ramps and loading dock. vehicles. and leased space; and on any property. including entry areas to any Upstate facility. i understand that Upstate is a smoke-free/tobacco-free Campus. Agreement I hereby authorize the investigation of all information contained in this application and other attached documents provided (is. resume. cover letter. etc.). i understand that misrepresentation or omission of facts called for may be grounds for not employing me. or dismissing me after employment. False statements made herein are punishable Class A misdemeanors pursuant to Section 210.45 of the Penal Law of the State of New York. Upstate Medical University resarves its rights to pursue legal redress for false statements pursuant to the New York State Penal Law. Further. I understand that my offer of employment is contingent upon my ability to perform. with reasonable accommodation. the job for which i am hired. Such determination shall be based on a physician's job-related medical examination. x-ray. and laboratory procedures. Such exam is consistent with business necessity. and requires that I do not pose a direct threat to the health or safety of patients. co-workers or other individuals in the workplace. Upstate Medical University is a drug free workplace. and prohibits the possession. sale. and/or use of illegal drugs and the use of alcohol in the workplace. I have read the application and attest that the facts and statements contained herein are true and correct to the best of my knowledge. I understand that false statements made herein are punishable as a Class A misdemeanor pursuant to Section 210.45 of the Penal Law Code of the State of New York BY SIGNING BELOW. certify that I have read and agree with these statements. A 111.1"; . Applicant's Name Applicant's Signature Danielle Laraque?Arena, MD, FAAP President Upstate Medical University Syracuse, NY October 21, 2016 Dear Dr. Laraque-Arena, My life's work providing strategic, trusted advice in conjunction with driving actions in support of executive level officers handling complex agendas and substantial networks of contacts has enabled me to successfully manage cross?cutting organizational initiatives with a high?degree of integrity and confidentiality. From federal government to academia to healthcare, clients, managers, and partners have values my ability to design initiatives and provide high?level advice across multi-sector. These experiences along with my strong relationship?building skills with key internal and external stakeholders is an attribute that makes me an ideal candidate as your next Chief of Staff. The journey as a committed Chief of Staff has allowed me to flourish in my transition from federal government almost five years ago. I am accustomed to challenge and responsibility, including: developing and analyzing high?impact programs, interacting with all levels of government, business, and academia contacts. In addition my operational skills have permitted me in overseeing human and capital resources, managing critical programs, and coordinating sensitive negotiations. In just under five years, I have launched a performance?based evaluation and compensation initiative after 40 years of across the board raises and cuts, develOped a university?wide health and wellness program and, most importantly, ensured that my executive leaders are always on message and focused on those issues that continue to push the organization's mission and vision forward. Finally, my passion and commitment to diversity, equity and inclusion is an expected core value that is held closely throughout Upstate's mission. I will promote practices that create awareness, appreciation, aCCeptance and celebration of different cultures, beliefs and ideas. I offer you excellent writing skills, dynamic leadership, and strong management abilities. I am committed to leveraging my experiences and take on a more complex opportunity within a recognized institution by serving and guiding leadership, stewarding time and resource management and supporting project execution that benefits the overall health of the organization. The accompanying resume will give you an overview of my potential for making a contribution to Upstate, its leaders and community in need of a trusted confidant, leader and team member. Again, thank you for considering my qualifications and I look forward to hearing from you soon. Your confidentiality is kindly requested of my candidacy until such time when it becomes necessary to make public and contact my references. Thank you for your time and consideration. very respectfully, Sergio A. Garcia, r: mn- ruizmr I . 4 . v: ar?Jv: SERGIO A. GARCIA, MSC PROFESSIONAL EXPERIENCE I I NORTHEAST OHIO MEDICAL UNIVERSITY Vice Diversity, Equity and Inclusi'mr (2t) 1 2 EU I 6) Provided leadership in maximizing the use and impact ofthe President's time and leadership on activities of strategic importance, including overseeing the establishment of the Office of Diversity, Equity and Inclusion. Established excellence and high-performance in the management of the Office of the President, execution of Leadership Team (LT) and _ad-hoc L'l? meetings, and representation of the President in internal and external interactions with faculty, staff, alumni and community leaders. Executed review and overhaul of university?s budget formulation and preparation process to ensure continued ?nancial and programmatic alignment with university?s strategic plan. Principal executive sponsor of innovative performance evaluation management initiative that rewards high performing administrative and staffemployees. Developed and implemented a University Strategic Diversity Plan by collaborating with departments University?wide to identify opportunities and barriers to the University?s efforts to recruit anti retain a diverse community ofsuccessful students, faculty and staff; and lead and support diversity?building programs across campus. Represented the University to external audiences and collaborated with academic and administrative leaders to develop external community partnerships including global connections that serve institutional development goals. U.S. DEPARTMENT OF STATE (2011 ~2012) .s - - - way-1. n. try-:7 7? US. DEPARTMENT OF DEFENSE (2010 2011) INTERNATIONAL REPUBLICAN INSTITUTE Country Director - Nicaragua 2007 2009) Managed and operated second largest of?ce in Latin America with an effective $2.1 million annual budget. Directed all financial planning and expenditures. including independent auditing measures for each program and sub-grantee. Developed and implemented nationwide non?pro?t initiative to help stabilize and increase resiliency of at-risk communities affected by Nicaragua?s civil con?ict by establishing local public?private partnerships to invest and create education antl employment hubs in Nicaragua. Established effective ongoing impact metrics utilizing local community engagements like focus groups and community polling, and utiliZed polling results in continuous quality assurance and programming development of democratization efforts within indigenous civil society organizations. Assessed past and current gender based education and political mainstreaming programs in Nicaragua; adapted programming to result in greater educational and political participation ofwomen in historically underrepresented government and educational institutions. Senior Advisor Sudan 1 Re?developed and presented IRI/Sudan?s 2010?2012 Technical Assistance work plan pursuant to ?uid in~ country situational contingencies and request to re?ne programming. Development electoral mapping project in South Sudan based on tribal af?liation in support of democratization and stabilization objectives in South Sudan states. U.S. DEPARTMENT OF STATE Chief (2004 2007) Managed and advised front office leadership team. providing overall management and evaluation ofBureau?s global operations and programs totaling million. Aided Secretary of State to promote and ensure inter- agency coordination on policy and and further coordinated with congressional leaders and staff. i Analyzed and provided feedback for policy and program development of global programs on achieving sustainable results in prevention programs targeting rut?risk and communities, and addressing cross-cutting issues of gender affairs, demand reduction, and multilateral cooperation. 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