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