Application: Think Tank MBA 2012 1. Question Title * 1. Please provide the following information: Name: * Organization: * Address 1: * Address 2: City/Town: * State/Province: ZIP/Postal Code: * Country: * Email Address: * Question Title * 2. Position within organization? Question Title * 3. Organization Website Question Title * 4. Year Founded Question Title * 5. Organization Mission Question Title * 6. Staff at this organization are... Number Full Time None One 2-5 6-9 10+ Full Time Number menu Part Time None One 2-5 6-9 10+ Part Time Number menu Volunteer None One 2-5 6-9 10+ Volunteer Number menu Offer any additional comments here Question Title * 7. Select the option that best describes your organization Home office Rented office space Owned office space Other (please specify) Question Title * 8. Annual Budget of your institute in USD Question Title * 9. Do you have donors in the following fields? If so, how many? Number Individual 0 1-5 6-9 10+ Individual Number menu Foundation 0 1-5 6-9 10+ Foundation Number menu Corporate 0 1-5 6-9 10+ Corporate Number menu Government 0 1-5 6-9 10+ Government Number menu Other (please specify) Question Title * 10. Briefly list the major programs and activities of your organization Question Title * 11. Please provide 3 strengths and 3 weaknesses of your organization Question Title * 12. In 5 years, How do you see your organization making an impact in your country or region? What steps does your institute plan to take in order to accomplish that vision? Question Title * 13. What are your long term professional goals? How long do you plan to stay with your organization? Question Title * 14. Please list any Atlas programs or events you have participated in, if possible, include month/year. Question Title * 15. Please discuss how your current position adds value to your organization's mission. Question Title * 16. What skills and experience will you bring to the Think Tank MBA program? Question Title * 17. As part of the Think Tank MBA you will create a detailed strategic plan. How will this benefit you and your organization? Done