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Home
Our Approach
How We Work
Our Focus Areas
Funding
Initiatives
Wellness Collaborative
Alamance Achieves
ACRE Co-lab
Leadership Institute
For Alamance
Resources
Capacity Building
Conference Center
News & Impact
Annual Reports
About
Our Equity Journey
Our Team
Board of Directors
Conference Center
Leadership Institute Application
Has your executive director graduated from the Leadership Institute?
*
Yes
No
EXPECTATIONS: The Leadership Institute includes approximately 45 hours of session time as well as time for individual coaching sessions over a 9 month period. To graduate from the Institute, a participant is expected to attend each session in its entirety. The series dates and times are outlined on the Leadership Institute website page. The Institute also consists of 3 individual coaching sessions, as well as some pre and post work for each session. Participants who miss more than 2 sessions of training will not be allowed to graduate.
*
I understand and affirm that the purpose of the Leadership Institute is to increase my awareness and understanding of leadership and gain meaningful insights and skills.
I have read the expectations above and if selected to participate in the Institute, I agree to the terms and time commitment.
I have checked the session dates on the website (virtual and possibly in-person) and have verified that I can attend these sessions.
I agree to be fully present for virtual training sessions, learning groups sessions and coaching sessions. I will arrive on time with my camera on to fully engage in the program.
I agree to all of the above.
Name
*
First
Last
Organization Name
*
Tax ID Number, No Dashes
*
Job Title
*
Phone
*
Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Email
*
Please indicate your Race/Ethnicity
White/Caucasion
Black/African American
Hispanic/Latinx
Native American
Asian
Race not identified in this list
How did you find out about the Leadership Institute?
United Way email
United Way website
Impact Alamance website / email
Was referred by another agency
Other
EDUCATION: Please list your degree, certificate, or other professional training below. Your application will not be judged based on education level. This is for informational purposes only.
How long have you been with your current organization?
*
Less than 2 years
2-5 years
5-10 years
Over 10 years
How long have you been in your current position?
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Less than 2 years
2-5 years
5-10 years
Over 10 years
How do you define leadership and what does it mean to you?
*
Identify your top two strengths and how they would be an asset to The Institute, then identify your development opportunities and how you believe this program would be helpful to you.
*
Supervisor or Board Chair's Email
*
A supervisor or board chair's letter stating that they are supportive of your participation and engagement in the Leadership Institute is needed to complete your application.
*
Max. file size: 50 MB.
There will be two virtual sessions that we ask participants and their leader (supervisor or board member) to attend. Please choose which date will work for you and your leader below.
*
August 15, 10am-11am
August 20, 3pm-4pm
If you save this application to finish later, please enter your email when prompted and this system will send you a weblink for you to finish your application. Be sure to keep the email so you can finish later.
