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NCCJ Equity Leadership Alliance (ELA) Program Application 2024 - Cohort 3

PLEASE NOTE THAT THE INFORMATION FROM THIS APPLICATION WILL NOT BE SHARED OR LINKED TO YOUR COMPANY OR EMPLOYER.  IT WILL BE USED FOR STATISTICAL PURPOSES ONLY.
1.Please indicate the full name of your organization. (no acronyms please)(Required.)
2.The location of your organization is(Required.)
3.Type of Organization(Required.)
4.Applicant information(Required.)
5.How do you identify?(Required.)
6.What pronouns do you use?(Required.)
7.Please enter the name of the co-applicant from your organization.(Required.)
8.Please give us your supervisor's name, email and phone number(Required.)
9.Number of Employees at your organization.(Required.)
10.Employee Racial Identity of your organization by percentage.(Required.)
11.In thinking about your organization's level of comfort and understanding with the following topics where would you position it?(Required.)
Uncomfortable - needs more awareness and education
Neither comfortable or uncomfortable - neutral
Comfortable - employees are aware and educated on this identity
Ability
Ageism / Adultism
Body Size
Class
Gender
Race
Religion
Sex
Sexual Orientation
12.In thinking about your personal level of knowledge with the following topics where would you position yourself?(Required.)
Need more information
Solid understanding and more to learn
Solid understanding and I could teach about the topic
None of these
Ability
Ageism / Adultism
Body Size
Class
Gender
Race
Religion
Sex
Sexual Orientation
13.We want to hear your story. What drew you to this program? How can this program benefit you the most?(Required.)
14.What specifically would you like to learn more about regarding diversity, equity and inclusion (DEI)?(Required.)
15.Please share one or more incidents that your organization has dealt with related to DEI, with regard to any of the 9 identities: ability, age, body size, class, gender, race, religion, sex, or sexual orientation.(Required.)
16.Are there any situations or topics with regard to DEI that you are uncertain how to respond or handle?(Required.)
17.What additional knowledge, resources or training would you be most interested in for professional development?(Required.)
18.What additional information would be important for NCCJ to know about you and/or your organization?(Required.)
19.Is there anything we didn't ask you that you would like to comment on?
20.Do you foresee any conflicts or challenges with any of the dates?(Required.)
21.If you are accepted into the program, do you have any allergies - food allergies or other? If yes, please list.(Required.)
22.If you are accepted into the program, do you need any accommodations for in person or on ZOOM? (So we can prepare in advance.)