Institute Application Form

Please take a moment to complete the Nonprofit Executive Leadership Institute application form. All fields with a * are required.

If you are unable to complete this form online, you can send in a hard copy (96 KB PDF) version.

Participant Information

Name (for certificate) *

Name (for name tag) *

Title *

Organization *

Address 1 *

Address 2

City *

State *

Zip *

Phone *

Fax

Email *

I will need disability accommodation. (Cascade staff will contact you at least three weeks prior to the program to discuss special needs)

Yes

Background Information

Number of years you have been at your current organization/agency *

Number of years you have served in your current position *

Number of years you have worked in the nonprofit sector *

Number of years, cumulatively, you have held senior-level positions (ED, CEO, CFO, Deputy Director, or similar position) *

Provide brief responses to the following statements/questions. We recommended preparing your responses in a separate document and cuting-and-pasting them into this form. (The total length of each of your responses should not exceed a half page.)

Please describe your organization: its mission, functions or services provided, number of FTE employees, and annual operation *

Please describe the primary responsibilities of your current position *

What do you hope to gain from participation in the Institute and how will it be useful to you and your organization *

What are the two most significant challenges you currently face (or will likely face in the near future) in your role as a leader in your organization *

Resume

Copy-and-paste your resume or curriculum vitae into the field below. All formatting will be removed. For best results, use a plain text version prepared in a program such as Notepad (Windows) or TextEdit (Mac). *

Letter of Recommendation

Please copy-and-paste a letter of recommendation from one of your current board members (recommended, but not required)

Billing Information

All invoices should be sent to:

Name *

Organization *

Address 1 *

Address 2

City *

State *

Zip *

Phone *

Fax

Email *

Payment and Cancellation Policies

Payment Policy

After your acceptance into the Nonprofit Executive Leadership Institute, you will receive an invoice from Cascade Executive Programs that must be paid by March 1, 2012. If you are unable to pay by the deadline, please contact us at cascade@uw.edu. Acceptable forms of payment include:

Check: Make checks payable to the University of Washington and mail to Cascade Executive Programs, University of Washington, Parrington Hall, Box 353055, Seattle, WA 98195-3055. Please include the names of the participant and course on the check.
Credit Card: We accept Visa and MasterCard over the phone only. Please call 206.685.0523 after receiving your invoice to pay for the program. A receipt will be mailed to the cardholder within a month of
payment.
Purchase Order Number: If your agency is unable to submit payment until after a service is rendered, we accept purchase order numbers (PO#) as payment. The PO# may be included at the time of your registration, or emailed to cascade@uw.edu with the name of the participant, the course name, and the PO# as soon as possible following a registration.

Cancellation Policy

A participant may withdraw or substitute a qualified applicant without penalty on or before February 15, 2012. Qualifications of substitute candidates must be confirmed by Cascade Executive Programs. Full course tuition will be charged for participants who do not cancel in time and who fail to show on the first day of the session for which they are registered. Cancellations must be received in writing and require a written response from Cascade Executive Programs to be in effect. If a registrant fails to
attend without notification, full tuition is required. Please note
that failure to submit payment does not cancel you from the course.

If the cancellation or course-transfer deadline falls on a holiday or weekend, you should send cancelation requests via email. If this is not possible, be sure to email your cancellation request on the business day prior to the holiday.

I have read and agree to the terms of both the payment policy and cancellation policy *

Yes

Public Primary Links

Institute Application Form