Application

We are interested in learning more about who you are, your interests in civic life and your community, and why you are applying for this training. There are no “right” answers to the questions below. Please answer honestly and openly. 

IMPORTANT: *WE SUGGEST THAT WHEN YOU GET TO THE SHORT ESSAYS AT THE END, YOU WRITE IN A WORD DOCUMENT, SAVE IT, AND THEN COPY AND PASTE YOUR ANSWER INTO THE WEBFORM* If anything were to happen (a computer glitch, the internet dropping a connection etc.) and you need to fill out the application again, this will make the process much faster! Thank you for your understanding!

 

Name *
Name
Address *
Address
Phone *
Phone
Affiliated Organizations *
Have you ever been a member of, worked for, donated to, or taken action with any of the following Virginia Civic Engagement Table Partners? (Check as many as apply.)
We know that Virginia will be at its strongest when it is led by those who represent the great diversity the Commonwealth has to offer. This program seeks to strengthen Virginia by training a wide range of leaders that better reflect the residents of our state. Given that personal identity is different for every person and can include many factors such as gender, race, class, sexual orientation, and/or ability, how do you self identify? (Please answer in less than 200 words)
In the past 12 months, have you: *
What are the 3 biggest issues facing Virginia right now? *
Please Select 3 From The List Below
Now if you had to choose just one, which would it be? *
(300 words or less)
Please answer the following 2 short essay questions in full. WE HIGHLY SUGGEST YOU WRITE THESE FIRST IN A WORD DOCUMENT, SAVE THEM AND THEN COPY AND PASTE THEM INTO THE FIELDS BELOW. 500 WORDS OR LESS.
Reference #1 Phone *
Reference #1 Phone
Reference #1 *
Reference #1
Any relevant affiliations, titles, or ties
Reference #2 *
Reference #2
Reference #2 Phone Number *
Reference #2 Phone Number
Any relevant affiliations, titles, or ties
Reference #3 *
Reference #3
Reference #3 Phone Number *
Reference #3 Phone Number
Any relevant affiliations, titles, or ties