22nd Century Leaders 2022 Program Application (Program starts the weekend of Saturday, April 9th/10th, 2022)
Allow 10-15 minutes to complete. If you haven't already, please review the details at http://evolutionaryworkplace.com/22ndcenturyleaders

Note: Though not required, we encourage you to sign up in pairs or small groups of people that you interact with, or would like to interact with regularly, as it makes the work more fun and more relevant. Copy and paste this link to share with others: https://forms.gle/tXTN2XkYJcfBsNTJ7
Email *
How did you hear about the program? If a personal referral, who?
Who else (if anyone) are you applying with? If no one currently, can you think of 1-3 people in your geographical area (or elsewhere) that you would like to do this work with?
We're delighted to meet you! We're Cleo Manago and Jill Nagle. What is your name? *
Telephone number?
City, state or province, and country?
Which age group are you in?
Clear selection
If there a website or social media link that tells us more about you or your work that you're willing to share, please do so below.
What time zone are you in? *
What are you most passionate about leading or working on in 2021? *
What is your experience leading the thing you are most passionate about? What have been your greatest successes and biggest challenges? *
What do you anticipate will best support your efforts in 2022? (Check all that apply) *
The main program is eight day-long meetings over six months. The first meeting of the main monthly class will be Saturday April 9th and Sunday April 10th, 2022 9:00 AM - 5:30 PM Pacific time8 meetings over six monthsWeekend of April 9-10thSunday May 15thSunday June 12thSunday July 10thSunday August 14thWeekend of September 10th & 11th It will be hybrid in-person and online. In addition to this monthly day-long, we will have other offerings to support and enhance the work, based on the group members schedules and interests. Will this structure work for you? *
What if any personal or spiritual growth approaches, traditions, training programs or groups have you been part of in the past? Which of these has been most useful and why? Which has been least useful and why? *
What attracts you to this particular program? *
Dismantling white supremacy is a cornerstone of this program. All levels of experience are welcome. What is your level of experience with dismantling white supremacy? *
Bare-bones beginner
What is your level of commitment to dismantling white supremacy? *
Minimal commitment
Maximum commitment
How do you see dismantling white supremacy as relevant to your leadership goals? *
What is your ethnic background? (Check all that apply)
Anything else you'd like to share about your background, and how it shapes who you are and how you feel in the world? (For example, gender identification, nationality, sexual orientation, physical ability, and so on).
How do you feel about personal growth in a supportive and challenging group environment? *
Very resistant, but willing
Have you ever been asked to leave a group? If yes, why? *
The success of 22nd Century Leaders depends upon each member committing fully to both themselves, and to showing up for their cohort, if they so commit to the weekly check-in portion (which is optional). Can we count on you to keep commitments to your cohort members? *
What kinds of gifts would you bring to the other members of your cohort? *
What would be your greatest hope to gain from this group? *
Any fears or concerns?
Based on our request in the Cost and Logistics section (.036 of gross income as starting point), within which tuition range do you expect you would choose to pay? (Note: this is not a commitment.) *
In general, what are some good times for a brief follow-up conversation? All times below are Pacific time. *
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