Leadership for Community Transformation - Executive Session Application

Solving Problems. Shifting Systems. Activating Potential.

This form must be completed by individuals interested in being enrolled in the Leadership for Community Transformation Executive cohort. Please complete all sections of this application and submit by January 12, 2018. Questions? Please contact Mariah Tanner

You may also download PDF file of LCT Executive Session Application

Date of Application

Name

Organization

Mailing Address

City/State/Zip

Daytime Phone

Mobile Phone

What do you stand for? What do you burn for to create or to change in the community and in the world?

What do you hope to accomplish, in service of what you want to create above, in the next year? Within 5 years?

From your perspective and life experiences, what does it take to be a systems leader and create the impact you wish to see?

What steps will you take to protect this time for yourself and ensure you can fully participate?

What is your project?

What result is your project designed to produce?

What values is your project based on?

How do you/will you ensure these values are embedded in your project?

What systems and norms need to shift for your project to reach these results?