Project Blueprint - Organizational Cohort Registration

Please complete the brief registration survey for the Project Blueprint Organizational Cohort. We require the participation of an executive leader from your board and an executive leader from your staff. Selection will be based on motivation for applying, commitment to the Lancaster County community, and contribution to the overall strength of the cohort.

If you have any questions please contact Joel Janisewski, VP of Impact, at jjanisewski@uwlanc.org

Thank you,

United Way of Lancaster County

Question Title

* 1. Please provide your organization's contact information

Organization

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

Question Title

* 2. Board Executive Leader Registration

Name

Title/Position with Organization

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

Question Title

* 3. Staff Executive Leader Registration

Name

Title/Position with Organization

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

Question Title

* 4. Please briefly tell us why your organization is interested in participating in Project Blueprint, including describing your motivation for applying and your commitment to the Lancaster County community.

Question Title

* 5. Statement of Commitment

We are prepared to fully participate in Project Blueprint, including committing to attend each session and to complete accompanying assessments.