Pacific Northwest Nonprofit Executive Leadership Institute

2009 Application

February 8-13, 2009

 

Participant Information

Name (for certificate): 
Name (for name tag): 
Title: 
Organization: 
Address: 
City: 
State: 
Zip:
Phone: 
(enter as: XXX-XXX-XXXX)
Fax: 
(enter as: XXX-XXX-XXXX)
 (NR)
E-mail: 
Number of years that you have been at your current organization/agency: 
Number of years that you have served in your current position: 
Number of years that you have worked in the nonprofit sector: 
Number of years, cumulatively, that you have held senior-level positions (ED, CEO, CFO, Deputy Director, or similar position): 
   
I. Please copy and paste brief responses to the following statements/questions
(the total length of combined responses should not exceed 6000 characters)
 
A. Please describe your organization: its mission, functions or services provided, number of FTE employees, and annual operation budget.
B. Please describe the primary responsibilities of your current position.
C. What do you hope to gain from participation in the Institute? How will it be useful to you and your organization?
D. What are the two most significant challenges you currently face (or will likely face in the near future) in your role as a leader in your organization?
II. Please copy and paste a resume or curriculum vitae
(the total length should not exceed 6000 characters)

III. Please copy and paste a letter of recommendation
from one of your current board members

(recommended, but not required)
(the total length should not exceed 6000 characters)
 
Please check to indicate a need for disability accommodation.

   No  Yes
Cascade Executive Programs staff will contact you at least three weeks prior to the program to discuss special needs.

 

Billing Information

All Invoices Should Be Sent To:
Name:  
Organization:  
Address:  
City:  
State: 
Zip: 
Phone:  
(enter as: XXX-XXX-XXXX)
Fax:  
(enter as: XXX-XXX-XXXX)
  (NR)
E-mail:  

 

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