Peer Learning Circle Application Form

Title

Name *

First Name

Last *

Last Name

Email Address *

Phone Number *

Organization

Organization Budget

Organization Affiliation *

In which learning circle would you like to participate?

Executive Director

Senior Staff

Position(s) to which you report

Number of staff members that report directly to you?

How long have you served in your current role?

How long have you worked in your current organization?

How long have you spent working in the nonprofit sector?

How many years of professional experience do you bring?

How many years of experience do you have in management/supervisory roles?

Describe your leadership or management style

What is your highest level of education?

What professional training/certifications do you have?

Have you previously participated in professional or leadership activities/initiatives? If yes, please list those here

How did you benefit?

Please explain what motivates you to apply for the learning circle you indicated

What do you expect to gain from the experience?

How will your organization benefit from your participation in the learning circle?

Please indicate which of the following are of greatest interest to you (select 2)

Networking with peers

Problem-solving in real time

Development/expansion of business skills (ie. budgeting, internal communications)

Development/expansion of management skills (ie. motivation of staff, managing up)

Education in functional areas related to your current role

Education in functional areas beyond your current role

Other

Which topics are you most familiar/comfortable? (select 3-5)

About which topics are you most eager to learn? (select 3-5)

What additional information would you like to share about yourself and/or your interest in joining a foundation learning circle?