Fundraising and Development Certificate Application Form (2020)
We are delighted to process your application to the Center for New Leadership's Fundraising and Development Certificate program. Applications will be accepted on a rolling basis until the class is full.

The following is an initial survey to get to know a little bit about your background and goals, and to have a picture of the organization you represent.

So that we can further tailor our training and coaching to meet your needs, once you are accepted into the program we will send you a more in-depth survey to learn more about your level of experience and what you hope to learn as part of this program.
First Name *
Your answer
Last Name *
Your answer
Name you would like us to use in class and correspondence -- if different from your first name as entered above.
Your answer
Your Personal Pronouns (for example she/her, he/him, or they/them)
Your answer
Email *
This should be the address that you want to use for all Certificate-related email. Please think carefully about whether you want to use a work or personal account.
Your answer
Street Address *
Your answer
Town/City *
Your answer
State/Province *
Your answer
Zipcode/Postal Code *
Your answer
Best contact phone number *
Your answer
Personal Statement *
Please explain, in a paragraph or two, your experience with fundraising and development, your aspirations for the future, and how you would benefit from completing the Fundraising and Development Certificate Program at this point in your career. We recommend that you compose your reply in a word processing program, save it, then copy and paste it here.
Your answer
Name of your organization/employer
Your answer
What is your role in your organization?
Please share your job title. If you have roles not typically associated with your title, please feel free to elaborate on you responsibilities.
Your answer
Location of your current organization
Please provide the city/town and state in which your organization is physically located.
Your answer
Do you plan on having more than one person from your organization attend the Fundraising and Development Certificate Program?
Do you anticipate that your organization will help pay for your participation in this program?
How many people in your organization are actively involved in fundraising and development activities? Please list the job titles and their roles.
Your answer
How many "full-time equivalent" staff members do you have at your organization? If you work in a branch office, please tell us about your particular branch.
How did you hear about the Fundraising and Development Certificate program? *
Your answer
Accessibility and Other Information
Do you have any accessibility requests? Note: parking may be up to two blocks from the training location. Please let us know here if you'll need assistance. Are there other things we should know about your participation in the program?
Your answer
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