FPL Circles Application Form

Application-Full Potential Leadership Circles

* Indicates required field

Name *

First

Last

Nickname/Preferred Name (Optional) *

Your Pronouns *

Preferred Mailing Address *

Line 1

Line 2

City

State

Zip Code

Country

Preferred Email *

Mobile Phone Number *

Current Role/Title *

How long have you been in current position? *

Current Organization *

Tell us about the organization you work for (can include information such as size, mission/purpose, age, geographies served, etc): *

LinkedIn Profile Url *

Upload Resume if no LinkedIn *

Max file size: 20MB

What sector do you work in? (e.g. nonprofit, philanthropy, social impact, for-profit, B-Corps, government, etc.) *

Tell us about your management experience (either as a direct supervisor or managing people on projects) *

Please briefly describe what being a mission-driven leader means to you. *

What do you most hope to gain from this program? *

This program is an investment and commitment to yourself, but also to the peers you will be learning with. What will you do to ensure you can be present and prepared for all of the live sessions? In other words, can we count on you to be a present and engaged participant? Is your manager prepared to give you the space to participate even if this falls during normal working hours? *

With exception of our Kick-Off and Closing Retreats, sessions occur the 3rd Thursday or Friday each month, depending on which group you are placed in. Though we cannot guarantee your first choice, please let us know which time slot you prefer:

First Choice *

Thursdays 9-10:30 am PT Fridays 9-10:30 am PT No preference

Additional comments (optional) *

What would you like to share about your identity, if anything, that you believe may be helpful for us to know or consider if you are accepted? For example, this can include an aspect of your identity that you'd like us to consider when matching you with a peer group (e.g. race, ethnicity, gender, age, or any other aspect of your lenses or identity you'd like us to know) or anything you feel is important for us to understand about you. (Optional) *

Do you require tuition assistance? In no, press submit to complete enrollment. If yes, please answer the remaining questions and then press submit. *

No--please scroll to the bottom and hit "submit" Yes--please answer the remaining questions

Global Citizen Year will be providing limited tuition assistance. Full Potential Ventures is collecting the following information in order to aid the consideration of all applicants and distribute funds as equitably as possible to ensure access to the program for all.

Which best describes your annual compensation (salary plus bonuses)? *

Below 40k 41k-60k 61-75 Above 75k

We encourage all participants to engage in a discussion with their employer about their participation in this program and their employer's willingness to financially support their professional development. Which best describes your situation? *

My employer is willing to share the cost of the program I have had a discussion, but my employer is not willing to pay anything at this time I am not able to discuss with my employer

If employer is willing to share the cost, please state how much they will contribute *

You may provide any additional information about your request here if you'd like *

Ready to submit?

One last thing before you submit...if you are not already part of our email list, would you like to be? You will receive two emails a month with highly curated material geared at inspiring your best leadership. Every once in a while you may receive a couple more emails if we have something special and time-sensitive happening. *

Yes No I'm already on the email list :)

Submit