Application

Consortium for Social Enterprise Effectiveness

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Name

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First Name*

Last Name*

Nickname

Job Title

Company*

Is the address below your:*

Home Address

Work Address

Address

Apartment #

State*

City*

Zip Code

Daytime Phone*

Cell Phone

Email*

Website

How did you hear about this program? (Mark all that apply.)

Other Sources:

1. What interests you most about this program? What are some of the main reasons you would like to attend, and/or what do you hope to gain from attending this program?*

2. What are the goals and mission of your organization?*

3. How would you describe your organization's workforce? For example, approximately how many paid employees and volunteers do you have? (Your response doesn't need to be exacact. Provide enough detail to help us understand the general size and structure of your organization.)*

4. How would you describe your role in the organization? For example, to whom do you report? Who reports to you? Do you have regular contact with your organization's board of directors?*

5. What is one or more board-level issue(s) your organization must address in the coming year? Please focus on issues that are critical to your organization's future, and those you have real influence over and will be held accountable for addressing.*

NOTE:

Competitive, need-based scholarships are available to cover up to half the tuition cost. Scholarship requests are reviewed on a case-by-case basis by the program director, Alex Miller. Scholarships are competitive, so early submission is recommended. To apply for a program scholarship, please complete question No. 6.

6. What is your financial need, and how much of the tuition are you able to fund yourself? Please include the amount of scholarship support you are requesting based on this need.

ATTENDANCE POLICY:

Successful completion of the CSEE program requires a commitment to attend all scheduled sessions and complete all assignments on time. Unforeseen emergencies do happen, and for this reason, students are allowed to miss half a day during the 10-month program. Classes are recorded for these purposes. If a student misses more than the allowed half day, they must attend the missed portions of the residency period(s) with the next year’s class in order to earn the course certificate. By checking the box applicants convey their understanding of and commitment to the CSEE attendance policy

I Agree*

I Agree