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Your Contact Information
Please share your contact information so that we can send you materials (via email and snail mail) and connect you with other program participants.
Primary Mailing Address
Date of Birth
Please select…FemaleMaleTrans MaleTrans FemaleGender Variant/Non-Binary/Non-ConformingNot Listed (please specify)I prefer not to share my gender identity
Please select…American Indian or Alaskan NativeArab, Middle Eastern, or North AfricanAsian or Asian AmericanBlack or African AmericanLatinx or HispanicMulti-racial or Multi-ethnicNative Hawaiian or Pacific IslanderWhite or CaucasianI prefer not to share my racial/ethnic identity.Not Listed (please specify)
Food Preferences / Restrictions
Please indicate any food allergies you have in the ‘other’ field
Other Food Allergies & Preferences:
If you require accommodations to participate in the three full-day workshops, please list them below (e.g., access to a wellness room)
We will take group photos during workshops and may use them on social media, our website, or in marketing materials. Do you agree to be included in these images?
Your Work and Experience
Current Job Title
Total years of full-time work experience as of Jan 2019
How many years have you been a manager?
What types of management responsibilities do you have? (Select all that apply.)
Manage budgetsManage direct reportsManage fundersManage projectsManage stakeholdersManage teamsN/A
Have you received any leadership or managerial training since becoming a manager?
What is a management skill you want to develop, and why? Please respond in 1-2 sentences.
Your Supervisor’s Information
Supervisor’s First Name
Supervisor’s Last Name
The information you provide below will be shared with the other members of your Managing for Success cohort.
LinkedIn Profile Link
Bio (max 200 words)
Please upload a current headshot
This headshot will be included in your cohort’s bio file and posted on the ProInspire website. Use the naming convention: LASTNAMEFIRSTINITIAL.JPG.
Are you able to commit to fully participating in each of the three workshops and completing all program prework/homework (approximately 2-3 hrs per month)
Who will be paying the registration fee?
My organization will be paying my feeI will be paying the fee myself
We have limited partial scholarships available to offset program fees for participants whose organizations cannot sponsor them.Would you like to be considered for a scholarship?
Please upload an essay that answers the following two questions: 1) How much financial support are you seeking? 2) How will this program benefit you? Please keep this at maximum 300 words, and title the file “FirstName_LastName_Scholarship.” If you are applying for a scholarship please choose the option to be invoiced while we review your application.
Please select…Budget above $5 millionBudget between $2-5 millionBudget below $2 million
How will your program fee be paid?
Via credit cardPlease send an invoice
Please select…Early BirdRegular
Please provide the name and email address of the individual who should received the invoice.
Name on Card
Please enter the email address where your registration confirmation should be sent
You have reached the end of the application. By submitting you agree to our Managing for Success terms and conditions. Are you ready to submit?
Yes, my application is complete.
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