2025 PASE Executive Leadership for Small Agencies Application

PASE is accepting applications from Executive Directors for our 2025 Executive Leadership Series for Small Agencies. This series of roundtable discussions led by PASE expert consultants and senior staff, allows organizational leaders to gather and plan for their agency’s future, share resources, and create and build partnerships with organizations facing similar challenges. While multiple participants from each organization are welcome to join sessions throughout the series, in order to benefit most from the executive leadership series, we are asking the primary applicant (Executive Director) from each organization to commit to attend at least 5 of the 6 roundtable sessions.

Organization Name*

Organization Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Does this organization operate multiple sites?*

YesNo

Organization Website*

Twitter [if not applicable, please enter N/A]*

Instagram [if not applicable, please enter N/A]*

Facebook [if not applicable, please enter N/A]*

Annual Operating Budget*

Youth Programming Budget*

Does your organization have 501(c)3 status?*

Executive Director Name*

First NameLast Name

Executive Director Phone Number

Please enter a valid phone number.

Executive Director Email*

example@example.com

Gender

Race/Ethnicity

Additional Contact Name

First NameLast Name

Additional Contact Job Title

Additional Contact Phone Number

Please enter a valid phone number.

Additional Contact Email

example@example.com

Number of Full-time Staff*

Number of Part-time Staff*

Number of Volunteers*

Number of Youth Served*

What grades does your organization serve? (Check all that apply)*

Program Service Areas (Check all that apply)*

Services provided in*

2025 PASE Executive Leadership for Small Agencies Application

Questions?

Organization Information

Participant Information

Additional Contact

Staff and Programming

Application Narrative