Community Development Works is a program of The Rapides Foundation
318.443.7880

Cenla Execbuilders Application

Date*
GENERAL INFORMATION
Title*
Mr. Ms. Mrs.
Executive Director or Senior Staff: Mr. / Ms. / Mrs. (Circle)*
Nonprofit Name*
Official Job Title*
Organization Address*
City*
State*
Zip Code*
Phone*
Fax
Cell Phone
E-mail*
Alternate Email
Website
Home Address*
City*
State*
Zip Code*
Education/Degree(s)*
Licenses/Certifications
What brings you to this program? (check all that apply)*
  • My Board Chair Board required or asked me to participate
  • A colleague encouraged me to apply
  • I was interested in enhancing my leadership skills
  • I want to enhance my management skills as a nonprofit executive
  • I believe it will help me connect with other people in my role
  • I believe it will help me strengthen my relationships with my Board and staff
  • Some other reason, what?
EXPERIENCE
What level of experience do you have as a nonprofit Executive Director or nonprofit Senior Staff?*
Very little to no experience (less than a year, new to nonprofits)
Some experience (two to three years)
Moderate experience (four to ten years)
Extensive experience (ten years or more)
If Extensive experience, how many years exactly?
Do you manage staff or volunteers in your nonprofit?*
No Yes
How long have you been working in the nonprofit sector? Years / months*
Years Months
Indicate the total number of years or months you have worked in the nonprofit sector*
What roles have you had in your nonprofit experience? (check all that apply)*
Executive Director Board Member
Other nonprofit staff Consultant / Trainer
Volunteer
How well informed do you feel you are now about the current state of knowledge or practice in each of the following areas?
Leadership*
Very well informed Somewhat informed Not very well informed
Nonprofit Operations*
Very well informed Somewhat informed Not very well informed
Strategic Thinking and Planning*
Very well informed Somewhat informed Not very well informed
Communications: Internal and External*
Very well informed Somewhat informed Not very well informed
Public Relations*
Very well informed Somewhat informed Not very well informed
Teambuilding*
Very well informed Somewhat informed Not very well informed
Mentoring*
Very well informed Somewhat informed Not very well informed
Change Leadership and Management*
Very well informed Somewhat informed Not very well informed
Would you like to obtain Coaching Services following the training?*
No >>> Track l: Executive Director only seeking training
Yes >>> Track ll Executive Director seeking training and coaching services for a limited time following training
How do you anticipate your learning from this program will help you in your nonprofit role?*
Return this application along with
  • Participant Commitment Form
  • Nonprofit Partner Sponsoring Agreement
  • Photo Release Form
  • Participant Online Profile with your picture and nonprofit logo

Fax to: 318-448-4473, Attn: Cenla Execbuilders or Mail to: Community Development Works

Attn: Cenla Execbuilders
1101 4th Street, Ste. 101B
Alexandria, LA 71301

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