Organization Name and Address
Phone:
Fax:
Email:
Web:
Organization Mission Statement:
Annual Budget:
Staff size:
No. of Paid Staff:
No. of Volunteers:
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No. of Board members:
Name of Executive
Director (Applicant)
Date
Executive Director
Board President
Number of years as E.D.
Please describe in detail what you hope to accomplish by participating in this program.
We fully understand the success of this program not only depends on the work of the Executive Director, but also the cooperation and participation of the organization’s Board of Directors, management and staff. We jointly endorse this Application. The Executive Director will attend all training sessions, complete a project and spend sufficient time with the ESC coach to assure success of the program. We agree to pay a fee of $1,000 by the first session: Oct. 1, 2009, and remaining fee by program completion. We understand this low fee is possible thanks to the generosity of Wells Fargo Foundation.
(Electronic submission assumes authorization of those names submitted below.
)
Application Deadline: August 17 2009.
NOTE: Due to the high amount of email we receive, please confirm ESC's receipt of this application by contacting Program Director Aileen Preonas or Program Assistant Soralla Marquez at 213.381.2891 after clicking the "Form Submit" button below.
Thank you!
