FPLP Application Form

Application-Full Potential Leadership Program

* 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 *

Years in current position *

Current Organization *

Organization Annual Budget *

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.) *

Years in leadership positions (director-level or equivalent and above) *

Describe your level of influence in your organization? Where and how do you have the ability to impact change? *

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

What are your greatest challenges as a leader? Greatest strengths? *

We strive to create a safe, caring community that also values direct yet compassionate feedback. Please tell us how this aligns with who you are as a leader. *

What would your co-workers say are your greatest contributions as a colleague and leader? Do you agree with them? *

What would your co-workers say are your greatest deficits? Do you agree with them? *

This program is an investment and commitment to yourself, but also to the peers you will be learning with. We understand that during an 8-month span everyone will have challenges and may need to miss a class or two. What will you do to ensure you can be present and prepared for live sessions as much as possible? In other words, can we count on you to be a present and engaged participant? *

With the exception of our Kick-Off and Closing Retreats, Group Seminars are generally scheduled the second Wednesday of the month* from 9-10:30 am Pacific Time.
Peer Practicums occur the 4th Tuesday or Wednesday of the month*, depending on what group you are placed in. (*please refer to the course calendar for the complete list of dates).

Though we cannot guarantee your first choice, please let us know which Peer Practicum time slot you prefer:

First Choice *

Tuesdays 9 am PT Wednesdays 9 am PT

What would you like to share about your identity as a leader, 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 coach (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) *

If you have a Promo Code, enter it here *

Do you require tuition assistance? If no, please proceed to the end and submit to complete application. If yes, please answer the *Tuition Assistance* questions and then press submit. *

No Yes

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

Below 75k 75k-100k Above 100k

*Tuition Assistance Requests* 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 if I receive a scholarship My employer is willing to share the cost regardless, but I personally need the scholarship to fulfill my financial part I have had a discussion, but my employer is not willing to pay anything at this time This does not apply to me (I am self-employed, an entrepreneur, about to leave my current employer, etc)

*Tuition Assistance Requests* Do you identify as an Emerging BIPOC Leader (e.g. someone who identifies as BIPOC that has 3+ years of director-level experience with a desire to step into a senior-level role sometime in the next 1-3 years)? Please briefly explain. *

Each cohort we offer one issue-specific full scholarship. (Past cohorts have included climate change, racial justice, and immigration/refugee rights). The Fall 2022 Catalyzer Scholarship will be offered to a leader working on either Reproductive Rights or Climate Catastrophe Solutions. If you would like to be considered for this scholarship, please describe your commitment to work in this area. *

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 :)

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