Emerging Leaders Development Program

Leadership Development Program Application 2023

Thank you for applying for United Way’s Leadership Development Program! This application will take approximately 20 minutes to complete.

The Leadership Development Programs are designed to increase awareness of one’s own individual leadership style, gain a greater understanding of cultural and historical perspectives, influence decisions impacting our community and inspire a personal commitment to community and civic engagement in an effort to promote diversity and inclusiveness on community boards and committees within our region.

Please let us know what program you are applying for.

The Emerging Leaders Development Program is offered to those who are between 21 and 40 years old.

I understand the conditions above and affirm that I am eligible

The Pride Leadership Development Program is offered to those who identify as a member of the LGBTQIA+ community

I understand the conditions above and affirm that I am eligible

The African American Leadership Development Program is offered to those who identify as a person of African American heritage.

I understand the conditions above and affirm that I am eligible

The Latino Leadership Development Program is offered to those who identify as a person of Latino heritage.

I understand the conditions above and affirm that I am eligible

The Development of Indo-American Leaders Program is offered to those who identify as a person of Indo-American heritage.

I understand the conditions above and affirm that I am eligible

Personal

First Name

Middle Initial

Last Name

Pronouns

Other Pronouns

Gender

Other Gender

Self -Identification

Date of Birth

Please select how you best describe your ethnicity

Other ethnicity

Need special accommodations? please select any that apply

Address

City

State

Zip

County

How long have you lived in the area?

Cell Phone

Home Phone

Personal Email

Employment (if applicable)

Employer

Job Title

Department

Work Address

Work City

Work State

Work Zip

Work Phone

Work Email

Supervisor First Name

Supervisor Last Name

Supervisor Email

Education

What is the highest level of your education?

Other education level

Preferences

Preferred Phone

Preferred Email

Preferred Address

Preferred First Name

How did you hear about United Way's Leadership Development Program?

Employer	United Way's Website
Article	Television
Friend	Work Colleague
Alumni	Other

Please answer the following questions in 250 words or less

What do you hope to gain from your participation in the Leadership Development Program?

Please explain what about serving on the board or committee of a local nonprofit organization resonates most strongly with you?

What would you like to gain personally and professionally from board or volunteer community service?

What expertise and skills do you bring as a member? (Please select all that apply)

Accounting/Auditing	Administration/Management
Advertising	Agriculture/Farming
Architecture	Arts
Association Management	Banking/Finance
Biotechnology	Business Development Planning
Community Organizing	Computers/Programming
Computers/Technology	Construction
Consulting	Consumer Products
Education (Higher)	Education (K-12)
Engineering	Entertainment/Culture
Entrepreneurship	Environmental/Sustainability
Event Planning	Executive Management
Fashion/Apparel	Finance/Investment
Financial Service	Fundraising
Government/Public Service	Grant Writing
Health Care	Hospitality/Restaurant
Human Resources	Insurance
Legal	Manufacturing
Marketing/Sales	Media
Military	Nonprofit Operations
Organizational Development	Policing/Firefighting/EMS
Public Relations	Publishing
Real Estate	Religious
Research/Evaluation	Retail
Risk Management	Science and Engineering
Social Media	Sports and Fitness
Strategic Plans	Teaching (0-5)
Teaching (Higher Education)	Teaching (K-12)
Telecommunications/Broadcast	Utilities
Written Communication

Leadership Training

Please list any leadership training you have attended in the past two years.

Name of Training

Year Started

Year Ended

Year difference

Community Engagement

Please enter any organization and/or type of service to which you have volunteered in the past two years.

Organization

Role

Year Started

Year Ended

Year difference

Areas of Interest for Community & Civic Engagement

For the following categories, please select all areas of interest that apply.

Animals

Animal RightsWelfare and ServicesWildlife ConservationZoos and Aquariums

Arts and Culture

LibrariesHistorical Societies and Landmark PreservationMuseumsPerforming Arts/Dance/Music/TheatrePublic Broadcasting and MediaVisual Arts

Community Development

Business Development/Capacity BuildingCommunity FoundationsHousing and Neighborhood DevelopmentUnited Ways

Education

Adult Education Programs and ServicesBoy & Girl ScoutsEarly Childhood Programs and ServicesEducation Policy and ReformFinancial Empowerment or ProtectionScholarship and Financial SupportSpecial EducationSports/AthleticsWorkforce Development/Job TrainingYouth Education Programs and Services

Environment

AgricultureBotanical GardensParks and Nature CentersClimate Change/Pollution ControlEnvironmental Protection and Conservation

Health

Diseases, Disorders and DisciplinesHospitals/Health CentersMedical ResearchMental HealthNutritionPatient and Family SupportTreatment and Prevention Services

Human and Civil Rights

Advocacy and Education	BIPOC Rights
Civic Engagement/Participation	Criminal Justice
Democracy and Government	D.E.I
Human Rights and Civil Liberties	Immigration Rights
Legal Services	Intellectual Developmental Disabilities
LGBTQ+ Rights	Race and Justice
Women’s Rights	Children's and Family Services
Domestic Violence	Emergency Response/Disaster Preparedness
Food Banks	Food Pantries and Food Distribution
Homeless Services	Multipurpose Human Service Organizations
Seniors	Social Services
Special Needs Populations	Substance Abuse Services
Volunteerism	Youth Development
Shelter and Crisis Services

International

Development and Relief ServicesHumanitarian Relief SuppliesInternational PeaceSecurity and AffairsMicrocredit and Lending

Religion

Religious ActivitiesReligious Development

Research and Public Policy

Non-Medical Science/Technology ResearchSocial and Public Policy Research

Other
(separate each entry with a comma)

If you need scholarship assistance in order to participate in United Way’s leadership development programs, please write a brief explanation to explain your need (250 words or less)

Please upload your resume

All applicants will receive notification regarding whether or not they are admitted into the leadership development program. If admitted, all applicants will be formally interviewed by the interview and selection committee prior to July 29.

By submitting this application, I agree to do the following:

On-time and full attendance at all in-person and virtual sessions.
Use the training and acquired skills to expand my role as a community leader.
Complete any follow-up evaluations/surveys.
Open, honest and respectful communication in all discussions.
Timely completion of all program activities.
Provide my own electronic device and Wi-Fi access.

By checking this box I acknowledge that all statements made in this application are accurate to the best of my knowledge.

The DIAL Leadership Development Program will run in person on Saturday, September 16, 2023 from 8:30-4:30 pm.

PROGRAM REQUIREMENTS

By submitting this application, I agree to do the following:

Attend the DIAL training session and participate in the program to the best of my ability.
Complete any follow-up evaluations/surveys
Following the training session, coordinate meetings with my assigned mentor to discuss community leadership opportunities.
Use the DIAL training to expand my role as a community leader.
If placed on a board, committee or community project, serve for at least one term.
Allow DIAL and United Way to include my name in its volunteer opportunities database.

PROGRAM INFORMATION

DIAL is a one-day program that includes various speakers covering topics such as board governance, fundraising, PR, networking, mentoring, and much more.
The training is FREE with breakfast and lunch included.

If you have any questions or need additional information, please contact DIAL Chair, Bijal Thakkar, at (512) 289-6389 or bij55@hotmail.com or Abhas Kumar at (510) 220-4949 or abhask@niit.com

By checking this box I acknowledge that all statements made in this application are accurate to the best of my knowledge.