Application: Think Tank Leadership Training 2012 Survey

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* 1. Please provide the following information:

Name: *

Organization: *

Address *

Web Address

City/Town: *

State/Province:

ZIP/Postal Code: *

Country: *

Email Address: *

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* 2. Position within Organization

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* 3. Year Organization was Founded

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* 4. Organization Mission

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* 5. Describe your organization's staff

	Number
Full Time	Full Time Number menu
Part Time	Part Time Number menu
Volunteer	Volunteer Number menu

Offer any additional comments here

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* 6. Select the option that best describes your organization's office space

Home office

Rented office space

Owned office space

Other (please specify)

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* 7. Annual Budget of your organization in USD

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* 8. Do you have donors in the following fields? If so, approximately how many?

	Number
Individual	Individual Number menu
Foundation	Foundation Number menu
Corporate	Corporate Number menu
Government	Government Number menu

Other (please specify)

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* 9. Briefly list the major programs and activities of your organization

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* 10. What is your professional background and motivation for working for a think tank?

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* 11. Please list any Atlas programs or events you have participated in. If possible, include month/year.

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* 12. On a scale of 1-5 please rank your proficiency in English

Poor

Average

Fluent speaking

Fluent speaking & written

Native tongue

Please fill out the following Needs Assessment.

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* 13. Please indicate your needs in a particular subject by selecting the appropriate option

	Of Great Need	Of Some Need	Of No Need	N/A
Develop a Mission/Vision	Develop a Mission/Vision Of Great Need	Develop a Mission/Vision Of Some Need	Develop a Mission/Vision Of No Need	Develop a Mission/Vision N/A
Develop a Strategic Plan	Develop a Strategic Plan Of Great Need	Develop a Strategic Plan Of Some Need	Develop a Strategic Plan Of No Need	Develop a Strategic Plan N/A
Create a fundraising strategy	Create a fundraising strategy Of Great Need	Create a fundraising strategy Of Some Need	Create a fundraising strategy Of No Need	Create a fundraising strategy N/A
Identify, research and solicit donors	Identify, research and solicit donors Of Great Need	Identify, research and solicit donors Of Some Need	Identify, research and solicit donors Of No Need	Identify, research and solicit donors N/A
Develop or enhance your "sales pitch"	Develop or enhance your "sales pitch" Of Great Need	Develop or enhance your "sales pitch" Of Some Need	Develop or enhance your "sales pitch" Of No Need	Develop or enhance your "sales pitch" N/A
Maintain relations with donors & stakeholders	Maintain relations with donors & stakeholders Of Great Need	Maintain relations with donors & stakeholders Of Some Need	Maintain relations with donors & stakeholders Of No Need	Maintain relations with donors & stakeholders N/A
Develop and work with a board of directors	Develop and work with a board of directors Of Great Need	Develop and work with a board of directors Of Some Need	Develop and work with a board of directors Of No Need	Develop and work with a board of directors N/A
Create a marketing strategy	Create a marketing strategy Of Great Need	Create a marketing strategy Of Some Need	Create a marketing strategy Of No Need	Create a marketing strategy N/A
Strategically brand and position your institute	Strategically brand and position your institute Of Great Need	Strategically brand and position your institute Of Some Need	Strategically brand and position your institute Of No Need	Strategically brand and position your institute N/A
Identify and engage your target audience	Identify and engage your target audience Of Great Need	Identify and engage your target audience Of Some Need	Identify and engage your target audience Of No Need	Identify and engage your target audience N/A
Attract "traditional" media (newspapers, tv, radio)	Attract "traditional" media (newspapers, tv, radio) Of Great Need	Attract "traditional" media (newspapers, tv, radio) Of Some Need	Attract "traditional" media (newspapers, tv, radio) Of No Need	Attract "traditional" media (newspapers, tv, radio) N/A
Use online communication	Use online communication Of Great Need	Use online communication Of Some Need	Use online communication Of No Need	Use online communication N/A
Develop a targeted research agenda	Develop a targeted research agenda Of Great Need	Develop a targeted research agenda Of Some Need	Develop a targeted research agenda Of No Need	Develop a targeted research agenda N/A

Please provide other areas of need

To complete your application, please submit a photo and resume to cindy.cerquitella@atlasnetwork.org by July 20th. These materials are required.

Please contact Cindy Cerquitella (cindy.cerquitella@atlasnetwork.org) with any questions or concerns