Thank you for your interest in the FSLN's 2022 Systems Leadership Retreat! The Retreat will take place virtually from Tuesday, September 20 - Friday, September 24. More information about the retreat is on our website here. Applications will be open through the end of July and applicants can expect to hear back about their status in early August.
We are committed to creating a network that reflects the diversity of communities across the country and represents a cross-section of the movement for equitable food systems. The following demographic questions will help us track our progress towards inclusivity.

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* 1. Name (First and Last)

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* 2. Email

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* 3. Contact Number

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* 4. Role/Job Title

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* 5. Organization

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* 6. City/Town

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* 7. State

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* 8. How would you identify your race/ethnicity? (Check all that apply)

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* 9. How old are you?

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* 10. How do you identify your gender?

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* 11. What Geographic space do you work in?

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* 12. What are your personal and professional roles in the food system? Please select one from the list below and elaborate in the comment box.

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* 13. What is the legal structure of your organization?

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* 14. What is your vision for a just and equitable food system? In what ways are you working towards this vision? (250 words max)

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* 15. What does leadership  mean to you? In what ways, formal and informal, do you use your own unique talents and aspirations to lead systems change? (250 words max)

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* 16. Why this retreat? Why now? How do you hope this retreat will support your journey as a leader and your efforts at food systems change? (250 words max)

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* 17. Please share with us the ways you have pursued and prioritized racial or other types of equity and inclusion, personally and professionally. How have your identities shaped how you pursue and prioritize equity and inclusion? (250 words max)

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* 18. Have you participated or been involved in any FSLN activities previously?

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* 19. If you require specific accommodations in order to fully participate in this activity, please let us know here for planning purposes:

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* 20. Please submit a brief personal bio (2-3 sentences). (If selected, this will be shared with fellow participants)

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* 21. Please submit a brief organizational bio (2-3 sentences). (If selected, this will be shared with fellow participants)

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* 22. By signing here, I confirm that if selected I can be online and fully present throughout the retreat (September 20-24), and have the support from my organization to do so.

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