Full Name Date of Birth Gender MaleFemale Email Phone Address Organization / Agency Current Role / Title Are you affiliated with HRCAP? YesNo Leadership Interest Why are you interested in the HRCAP Nonprofit Leadership Institute? What leadership skill or challenge do you hope to strengthen through this program? How will you apply what you learn to your work or community? Future Leadership Are you interested in future board, commission, or senior leadership roles? YesNoUnsure Commitment Acknowledgment Please confirm your ability to: Attend at least 75% of sessionsParticipate in the capstone projectEngage in coaching/mentoring activities Declaration confirm the above information is accurate.
