CDCLP COHORT IV APPLICATION
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
CDC/Nonprofit Organization
*
Title
*
The neighborhood or City you serve (i.e., St. Clair Superior, Lakewood):
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Why are you motivated to be an agent of change at a CDC/community-based non-profit?
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Please describe your leadership style. How do you hope CDCLP will further your development towards becoming a stronger, more effective leader?
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What are your three most important goals for personal/professional growth over the next year? Be specific and articulate how you would define success for these goals.
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What does social justice mean to you - particularly, for historically disenfranchised communities or populations, including people of color, immigrant populations, etc.? What have you or your CDC/non-profit organization done or would like to do in order to achieve greater social justice in the neighborhoods you serve?
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How did you become aware of the CDC Leadership Program?
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Coworker
Associate
CDCLP Graduate
Social Media
E-marketing
Other
This person recommended that I apply (if applicable).
First Name
Last Name
Please attach your resume to the application.
*
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