Clone of Visionaries Leadership Academy Application 25-26

Please thoroughly fill out the following application
Name

First NameMiddle NameLast Name
Birth Date

MonthDayYear
Gender
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Phone Number
Format: (000) 000-0000.
Education
Field of Study
Occupation
Have you previously studied or taken Islamic Studies Courses?
What is your experience working with the Muslim Community?
How has your experience working (or living) in the Muslim Community been? (Min. 100 words)

0/500
Why are you applying to be a Visionary? (Between 250-500 words)

0/500
Were you recommended by a Visionary Alumni, if so, please provide their name
Please provide a reference we may contact (Teacher, Mentor, Employer, Coworker, etc.)
Reference Name

First NameLast Name
Reference Email
example@example.com
Reference Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Visionaries Leadership Academy is a 9-month program that requires commitment in time, effort, and financial investment.Tuition for the program is $125/month for 9 months, or $1000 paid upfront.Are you able to commit to this tuition if accepted into the program?
If you require financial assistance, how much are you realistically able to contribute per month?
I understand Visionaries Leadership Academy (VLA) is an academic year-long program to help Muslims lead with insight and empathy by reviving faith-centric thinking and action. Knowing the commitment and rigor, I strive to uphold a standard of excellence and dedication.
Any Comments or Concerns?
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Please thoroughly fill out the following application