Your Name (required)

    Title/Position or Board Role (required)

    Name of Nonprofit Organization (required)

    Nonprofit Address (required)

    Your Email (required)

    Nonprofit Telephone and Fax (required)

    Nonprofit Organization Web site (required)

    National/Parent Organization (if applicable)

    Nonprofit Organization Web site (required)

    Home Address (required)

    Home Telephone (required)

    Preferred Mailing Address (required)

    Please enter information for an emergency contact.

    Race (optional)

    Current Position/Title (required)

    Years with Organization (required)

    Founding Date (required)

    Does your organization have a 501(c)3 nonprofit status (required)

    Organization's Annual Budget (in U.S. dollars) (required)

    Number of Paid Employees (required)

    Approximate Number of Volunteer Employees (required)

    Total Membership (if applicable)

    Size of Board (required)

    Size of Executive Committee (or similar) (required)

    Employees Reporting to You (required)

    Employees Reporting to You (required)

    Number of Affiliates/Chapters (if applicable)

    Please indicate the approximate percentage of your organization's funding from the following sources: (if you represent an affiliate or chapter, please give your affiliate or chapter information)

    % of Individual Donors (required)

    % of Government (all levels) (required)

    % Events (required)

    % Fees for Services/Products (all levels) (required)

    % Corporate Funding (required)

    % Foundations (required)

    % Endowment Income (required)

    % Other (please specify)

    Please describe the nonprofit organization you will be representing. Including a brief description of its mission, organizational objectives and activities. (required)

    Organizational structure, including your responsibilities and reporting relationships. (required)

    Geographical Spread. (The counties in which the organization is active, the presence of regional offices, the number of staff employed and the headquarters location.) (required)

    How does your organization (through mission or project) support South Carolina families so they have the resources to live out of poverty? (required)

    What do you consider to be the most critical issue(s) facing leadership in the nonprofit organization with which you are involved? (required)

    What are your overall leadership goals in attending this course? (required)

    Please list your positions in reverse chronological order, starting with your current one. If all positions are in the same company, please give the major promotional sequence. Please include the name of company, title or position, and dates of employment. (required)

    Please estimate your total years of professional and leadership experience: (required)

    The Sisters of Charity Foundation of South Carolina is committed to God's people represented in many races, ethnicities, languages, genders, religions and abilities. Diversity matters and is in the forefront of everything we do as an organization and in the decisions we make as a funder. Please explain in what ways you and your organization , overall, pays attention to and embraces diversity (e.g. demographics of populations served, staff/board/volunteer composition, etc.) (required)

    Have you attended other Sisters of Charity Foundation of South Carolina or Columbia College programs? If so, please list along with dates. (required)

    How did you hear about this program? (required)