Executive/Philanthropy Circle Application - Center for Nonprofit Excellence

Name*

First Last

Professional Title*

Email*

Phone*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Your Organization

Name*

Mission*

Major programs and services provided*

Annual operating budget*

Number of board members*

Number of paid staff*

Number of volunteers*

Is your position....*

If part-time, how many hours a week do you work?

Number of years in the nonprofit sector*

Number of years in current position*

Number of years with current organization

Do you currently supervise staff?*

If so, how many?

Do you currently have budgetary responsibilities?*

If so, describe your responsibilities:

Please upload a copy of your current resume*

Max. file size: 50 MB.

Why are you interested in participating in a Leadership Circle?*

What do you hope to gain?*

What contributions will you make to the nonprofit community?*

Reference Name*

First Last

Reference Organization*

Reference Phone Number*

Reference Relationship*

Please upload a brief letter of support from your direct supervisor or the organization's Executive Director

Max. file size: 50 MB.