Leaders Lab Application

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

A 6-month, online cohort to strengthen your competence and confidence to be a community-based leader. You will walk alongside practitioners from around the country as our team leads you to learn about and practice the 6 lenses for healthy and impactful community-based leadership.

Email *

Name

City and State

Email Address

Please select all that apply:

I live in the community I am representing

I work in the community I am representing

I volunteer in the community I am representing

Is your role affiliated with a community-based development group or organization?

Yes, my role is directly related to a community-based development group or organization.

No, my role is entirely independent of any community-based development group or organization.

Clear selection

If your role is affiliated with a community-based development group or organization, please share the name and website

What is the title of your role in this group or organization?

Tell us about your community. In a few sentences, describe the content in which you hope to strengthen your community-based leadership.

If selected to participate in Leaders Lab 08, what do you hope to gain from this experience?

Please select a payment option.

I am aware of the cost for participation and will be making a one time payment of $1,500

I want to discuss payment further

Clear selection

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of FCS Urban Ministries.

Does this form look suspicious? Report

Forms