GREATER RALEIGH CHAMBER OF COMMERCE
Greater Raleigh Chamber of Commerce
Leadership Raleigh
(Please type responses)
Leadership Raleigh Program Project Application Form
Nonprofit Organization: _________________________________________________
Mailing Address: _________________________________________________
_________________________________________________
City-State-ZIP: _________________________________________________
Primary Contact (Staff Liaison*) _________________________________________________
Phone: _________________________________________________
E-mail: _________________________________________________
*This person will be the primary staff member who will help to answer any questions or help to provide organizational support to the Leadership Raleigh team.
Secondary Contact: __________________________________________________
Phone: __________________________________________________
E-mail: __________________________________________________
Board Member Contact: __________________________________________________
Phone: __________________________________________________
E-mail: __________________________________________________
Years in Local Operation: __________________________________________________
Please type detailed answers to the following questions in a new document.
o Mission of the organization:
o Description of the project
o What goals or objectives would completion of this project meet for your organization?
o Is funding needed for the project? If so, is funding secured?
o Beyond the described project, are there additional opportunities to deepen the experience and connection to your organization? If yes, please list those items for consideration.
o What questions would you anticipate receiving about your organization and this project during an initial meeting with a Leadership Raleigh team?
o Are you familiar with the Leadership Raleigh program? If not, what questions do you have about the program and/or this opportunity?
o Please list any expectations you have in working with a Leadership Raleigh group:
o Estimated length of project (please note that the project should be one that can be completed by May 2015):
Commitment Statement for Leadership Raleigh Project
The completion and submittal of this project application represents the organization's commitment to be accessible and support the team from Leadership Raleigh. We agree to be available throughout the project timeframe to provide necessary resources to the Leadership Raleigh team in order to assist them in their efforts to complete this project.
Commitment of Organization Executive: ____________________________________________
Position: _______________________________________________________________________
Greater Raleigh Chamber of Commerce, PO Box 2978, Raleigh, NC 27602; fax to: 919.664.7097 or return via e-mail to gmcnamara@
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