The Colorado Family Leadership Training Institute
Colorado Civic Design Team Application

*Note: This application may take several minutes to fill out and your work cannot be saved. Please allocate 20-30 minutes to complete application.

* First Name:

* Last Name:

* County:

* Address:

* City:

* ZipCode:

* Home Phone:

* Cell Phone:

* Email:

* Organization/Company:

* Title:

PART I: Please submit this form, the information below and your essay responses to the questions below:

q Professional Resume;

q 3 References (including contact information);

q Additional information or comments for consideration.

Attach Resume

*

1. What is the significance of family and youth leadership to you?

*

2. How does family leadership influence family, community and public policy?

*

3. What work or voluntary experience have you had with family/youth leadership, if any?

*

4. Why do you believe family capacity building is significant?

*

5. Why are you interested in participating on the Colorado Civic Design Team?

*

6. Please describe your work and volunteer experience with group dynamics.

*

7. Please describe your experience with advocacy, community organizing, public policy and social change.

*

8. What is your experience working with diverse groups across age, race, class, and regions of the state?

PART 2: Tell us something about yourself:

* Do you have children?

Yes

No

If Yes, how many children do you have?

Other:

* Do you have children with special needs?

Yes

No

* Would you need childcare to allow you to participate in FLTI?

Yes

No

Maybe

* Do you have reliable transportation?

Yes

No

Maybe

What is your racial/ethnic background? (optional)

Other Racial/Etnic Background:

What is your gender? (optional)

Male

Female

Other

* Which of the following statements best describes your current employment situation?

Other Employment:

* What is your highest level of education?

Other Level of Education:

* What is your native language?

English

Spanish

Chinese

Russian

Other Language:

What other languages to you speak fluently?

English

Spanish

Chinese

Russian

Other secondary Language:

What is your occupation?

* Please share any special skills, abilities or experience you have that you believe would add value to the FLTI experience and team?

* Indicates Response Required

< HS or GED	HS or GED	2 YR Degree	Bachelors or 4 YR Degree	Master's, Doctoral or Professional (Law, Medical) Degree
Post Graduate Work

The Colorado Family Leadership Training Institute Colorado Civic Design Team Application

The Colorado Family Leadership Training Institute
Colorado Civic Design Team Application