LEAD2025
Please submit your application no later than close of business on February 7, 2025.
Personal Information
Name
*
First Name
Last Name
Home Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Mobile Number
*
Please enter a valid phone number.
Email
*
example@example.com
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone
*
Please enter a valid phone number.
Please list any food allergies or dietary restrictions. (Food will be provided at each session)
Organizational Information
Organization Name
*
Organization Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Work/Organization Phone Number
*
Please enter a valid phone number.
Website
*
Your title
*
How long have you been in your current role?
*
Organization Budget Size
*
Number of Staff
*
Number of Board Members
*
Social Media Handles
Please provide responses to the following questions in no more than 3-4 sentences.
1. How will participating in this cohort help you professionally/personally?
2. What is the greatest challenge for your organization other than funding?
3. If selected, what type of project would you like to pursue? (Projects should enhance organizational operations and/or sustainability.)
4. What does success look like for you at the end of the program?
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