Community Leadership Accelerator 2025—Registration and Getting to Know You Survey

Instructions

Thank you for making the decision to invest in your leadership and community. We are excited that you are taking this important step! If you have not already, please share information about this program with other leaders who you think would be a good fit.

We have designed the registration/getting to know you survey to learn more about who you are as a person and a leader. Please answer as honestly as you can.

Each year, we work to identify community partners who can help provide financial assistance. Funds can be requested through the registration process. The scholarship application link can be found at the end of this registration. Resources are limited and variable, so please only ask for what you need.

The CLA registration deadline is midnight on February 14. We will be reviewing registrations and scholarship requests in early March, with the goal of confirming your participation in the program by February 25, 2024.

In the meantime, please hold the following dates:

Opening Retreat: April 2, 3 and 4
Virtual workshops: May 7, June 11, August 13, September 17 (all 9-12:30)
Closing retreat: October 22, 23, and 24

The opening and closing in-person retreats will take place at the Sonoran Desert Inn and Conference Center in Ajo, Arizona

In community,

Bryn Jones, Gathering Elan

Sarah Griffiths, Sarah L. M . Griffiths

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* 1. Tell us a bit about yourself:

Name:

Organization(s):

Position(s):

Age:

City where you work:

City where you live:

Rural or urban:

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* 2. Contact information

Mailing Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 3. Name you want to be called

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* 4. What is your gender identity?

Woman

Man

Genderqueer or non-binary

Agender

Prefer not to respond

Other (please specify)

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* 5. What is your sexual orientation? Check all that apply.

Asexual

Bisexual

Gay

Heterosexual or straight

Lesbian

Pansexual

Queer

Prefer not to respond

Other (please specify)

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* 6. What is your racial or ethnic identity? (Select all that apply.)

African-American/Black

East Asian

Hispanic/Latinx

Middle Eastern

American Indian/Hawaiian or Alaskan Native/Indigenous within US

Indigenous outside of US

Pacific Islander

South Asian

Southeast Asian

White

Prefer not to respond

Other (please specify)

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* 7. Are you a person living with a disability, or differently abled?

Yes

Prefer not to respond

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* 8. If you answered yes above, please tell us a little more about how we could support your full participation in CLA.

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* 9. Is English your first language?

Yes

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* 10. Why are you interested in this program? What do you want to get out of it?

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* 11. Tell us a little about the personal and/or professional development that you've done to date.

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* 12. Describe where and how you currently show up as a leader.

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* 13. Describe where and how you previously have shown up as a leader.

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* 14. On a scale of 1-10 (10 being your ideal), how would you rate your work/life balance?

Clear

i We adjusted the number you entered based on the slider’s scale.

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* 15. On a scale of 1-10 (with 10 being the most ready), how ready are you for self-exploration?

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i We adjusted the number you entered based on the slider’s scale.

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* 16. When you think of yourself as an organizational and/or community leader, what 3 areas would you most like to develop in yourself?

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* 17. What strengths, qualities, and/or gifts do you bring to your leadership?

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* 18. This is a program aimed at developing diverse leaders who are grounded in their own leadership, can sustain themselves as leaders, value human connection and relationships, and can drive community change. What community change are you working towards and/or would like to work towards?

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* 19. Choose the number that best represents how you currently rate your ability in each of the areas (1 is low. 10 is high). How would you rate yourself?

	1	2	3	4	5	6	7	8	9	10
Overall confidence level as a leader	Overall confidence level as a leader 1	Overall confidence level as a leader 2	Overall confidence level as a leader 3	Overall confidence level as a leader 4	Overall confidence level as a leader 5	Overall confidence level as a leader 6	Overall confidence level as a leader 7	Overall confidence level as a leader 8	Overall confidence level as a leader 9	Overall confidence level as a leader 10
Managing conflict	Managing conflict 1	Managing conflict 2	Managing conflict 3	Managing conflict 4	Managing conflict 5	Managing conflict 6	Managing conflict 7	Managing conflict 8	Managing conflict 9	Managing conflict 10
Maintaining a positive outlook	Maintaining a positive outlook 1	Maintaining a positive outlook 2	Maintaining a positive outlook 3	Maintaining a positive outlook 4	Maintaining a positive outlook 5	Maintaining a positive outlook 6	Maintaining a positive outlook 7	Maintaining a positive outlook 8	Maintaining a positive outlook 9	Maintaining a positive outlook 10
Having a growth mindset	Having a growth mindset 1	Having a growth mindset 2	Having a growth mindset 3	Having a growth mindset 4	Having a growth mindset 5	Having a growth mindset 6	Having a growth mindset 7	Having a growth mindset 8	Having a growth mindset 9	Having a growth mindset 10
Practicing active listening	Practicing active listening 1	Practicing active listening 2	Practicing active listening 3	Practicing active listening 4	Practicing active listening 5	Practicing active listening 6	Practicing active listening 7	Practicing active listening 8	Practicing active listening 9	Practicing active listening 10
Developing others as leaders	Developing others as leaders 1	Developing others as leaders 2	Developing others as leaders 3	Developing others as leaders 4	Developing others as leaders 5	Developing others as leaders 6	Developing others as leaders 7	Developing others as leaders 8	Developing others as leaders 9	Developing others as leaders 10
Having awareness of and managing emotions (in yourself)	Having awareness of and managing emotions (in yourself) 1	Having awareness of and managing emotions (in yourself) 2	Having awareness of and managing emotions (in yourself) 3	Having awareness of and managing emotions (in yourself) 4	Having awareness of and managing emotions (in yourself) 5	Having awareness of and managing emotions (in yourself) 6	Having awareness of and managing emotions (in yourself) 7	Having awareness of and managing emotions (in yourself) 8	Having awareness of and managing emotions (in yourself) 9	Having awareness of and managing emotions (in yourself) 10
Having awareness of and managing emotions (in others)	Having awareness of and managing emotions (in others) 1	Having awareness of and managing emotions (in others) 2	Having awareness of and managing emotions (in others) 3	Having awareness of and managing emotions (in others) 4	Having awareness of and managing emotions (in others) 5	Having awareness of and managing emotions (in others) 6	Having awareness of and managing emotions (in others) 7	Having awareness of and managing emotions (in others) 8	Having awareness of and managing emotions (in others) 9	Having awareness of and managing emotions (in others) 10
Setting and maintaining boundaries	Setting and maintaining boundaries 1	Setting and maintaining boundaries 2	Setting and maintaining boundaries 3	Setting and maintaining boundaries 4	Setting and maintaining boundaries 5	Setting and maintaining boundaries 6	Setting and maintaining boundaries 7	Setting and maintaining boundaries 8	Setting and maintaining boundaries 9	Setting and maintaining boundaries 10
Taking care of yourself (mind, body, spirit)	Taking care of yourself (mind, body, spirit) 1	Taking care of yourself (mind, body, spirit) 2	Taking care of yourself (mind, body, spirit) 3	Taking care of yourself (mind, body, spirit) 4	Taking care of yourself (mind, body, spirit) 5	Taking care of yourself (mind, body, spirit) 6	Taking care of yourself (mind, body, spirit) 7	Taking care of yourself (mind, body, spirit) 8	Taking care of yourself (mind, body, spirit) 9	Taking care of yourself (mind, body, spirit) 10
Understanding yourself as an authentic leader	Understanding yourself as an authentic leader 1	Understanding yourself as an authentic leader 2	Understanding yourself as an authentic leader 3	Understanding yourself as an authentic leader 4	Understanding yourself as an authentic leader 5	Understanding yourself as an authentic leader 6	Understanding yourself as an authentic leader 7	Understanding yourself as an authentic leader 8	Understanding yourself as an authentic leader 9	Understanding yourself as an authentic leader 10
Understanding power and power dynamics	Understanding power and power dynamics 1	Understanding power and power dynamics 2	Understanding power and power dynamics 3	Understanding power and power dynamics 4	Understanding power and power dynamics 5	Understanding power and power dynamics 6	Understanding power and power dynamics 7	Understanding power and power dynamics 8	Understanding power and power dynamics 9	Understanding power and power dynamics 10
Collaborating and sharing power	Collaborating and sharing power 1	Collaborating and sharing power 2	Collaborating and sharing power 3	Collaborating and sharing power 4	Collaborating and sharing power 5	Collaborating and sharing power 6	Collaborating and sharing power 7	Collaborating and sharing power 8	Collaborating and sharing power 9	Collaborating and sharing power 10
Understanding your personal values	Understanding your personal values 1	Understanding your personal values 2	Understanding your personal values 3	Understanding your personal values 4	Understanding your personal values 5	Understanding your personal values 6	Understanding your personal values 7	Understanding your personal values 8	Understanding your personal values 9	Understanding your personal values 10
Able to see from and include perspectives other than your own	Able to see from and include perspectives other than your own 1	Able to see from and include perspectives other than your own 2	Able to see from and include perspectives other than your own 3	Able to see from and include perspectives other than your own 4	Able to see from and include perspectives other than your own 5	Able to see from and include perspectives other than your own 6	Able to see from and include perspectives other than your own 7	Able to see from and include perspectives other than your own 8	Able to see from and include perspectives other than your own 9	Able to see from and include perspectives other than your own 10
Connecting to your larger purpose	Connecting to your larger purpose 1	Connecting to your larger purpose 2	Connecting to your larger purpose 3	Connecting to your larger purpose 4	Connecting to your larger purpose 5	Connecting to your larger purpose 6	Connecting to your larger purpose 7	Connecting to your larger purpose 8	Connecting to your larger purpose 9	Connecting to your larger purpose 10
Aligning your actions with your intentions	Aligning your actions with your intentions 1	Aligning your actions with your intentions 2	Aligning your actions with your intentions 3	Aligning your actions with your intentions 4	Aligning your actions with your intentions 5	Aligning your actions with your intentions 6	Aligning your actions with your intentions 7	Aligning your actions with your intentions 8	Aligning your actions with your intentions 9	Aligning your actions with your intentions 10
Awareness and inquiry into complex challenges	Awareness and inquiry into complex challenges 1	Awareness and inquiry into complex challenges 2	Awareness and inquiry into complex challenges 3	Awareness and inquiry into complex challenges 4	Awareness and inquiry into complex challenges 5	Awareness and inquiry into complex challenges 6	Awareness and inquiry into complex challenges 7	Awareness and inquiry into complex challenges 8	Awareness and inquiry into complex challenges 9	Awareness and inquiry into complex challenges 10
Feeling empathy and compassion	Feeling empathy and compassion 1	Feeling empathy and compassion 2	Feeling empathy and compassion 3	Feeling empathy and compassion 4	Feeling empathy and compassion 5	Feeling empathy and compassion 6	Feeling empathy and compassion 7	Feeling empathy and compassion 8	Feeling empathy and compassion 9	Feeling empathy and compassion 10
Practicing humility	Practicing humility 1	Practicing humility 2	Practicing humility 3	Practicing humility 4	Practicing humility 5	Practicing humility 6	Practicing humility 7	Practicing humility 8	Practicing humility 9	Practicing humility 10
Appreciating and feeling gratitude	Appreciating and feeling gratitude 1	Appreciating and feeling gratitude 2	Appreciating and feeling gratitude 3	Appreciating and feeling gratitude 4	Appreciating and feeling gratitude 5	Appreciating and feeling gratitude 6	Appreciating and feeling gratitude 7	Appreciating and feeling gratitude 8	Appreciating and feeling gratitude 9	Appreciating and feeling gratitude 10
Communicating effectively	Communicating effectively 1	Communicating effectively 2	Communicating effectively 3	Communicating effectively 4	Communicating effectively 5	Communicating effectively 6	Communicating effectively 7	Communicating effectively 8	Communicating effectively 9	Communicating effectively 10
Making decisions	Making decisions 1	Making decisions 2	Making decisions 3	Making decisions 4	Making decisions 5	Making decisions 6	Making decisions 7	Making decisions 8	Making decisions 9	Making decisions 10
Fostering accountability in self and others	Fostering accountability in self and others 1	Fostering accountability in self and others 2	Fostering accountability in self and others 3	Fostering accountability in self and others 4	Fostering accountability in self and others 5	Fostering accountability in self and others 6	Fostering accountability in self and others 7	Fostering accountability in self and others 8	Fostering accountability in self and others 9	Fostering accountability in self and others 10

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* 20. This program is work, for your own growth, your organization or group's, and your community's. As such, all meetings will take place during the work-week. The opening and closing in-person retreats will take place at the Sonoran Desert Inn and Conference Center in Ajo, Arizona.

To experience the full impact of this program, you will need to define boundaries and carve out space. We recommend you block out an hour or two each week beyond the retreats, workshops and meetings to focus on what you are learning.

Outlined here are the program components:

Program: 6-month program with around 20-25 participants from Arizona, and possibly a few slots for participants outside of Arizona.

April 2025: 3-day in-person opening retreat:

4/2: 12:00 – 5:00

4/3: 9:00 – 5:00

4/4: 9:00 – 2:00

Virtual Workshops:

5/7: 9:00 - 12:30

6/11: 9:00 - 12:30

8/13: 9:00 - 12:30

9/17: 9:00 - 12:30

October 2025: 3-day in-person closing retreat:

10/22: 12:00 – 5:00

10/23: 9:00 – 5:00

10/24: 9:00 – 2:00

Other components:

EQ Assessment and debrief

Practicum—applying the principles in action—which culminates in a Leadership Memoir (required for completion of the program)

Two coaching sessions with each leader (one of which will be EQ debrief)

Participation in peer application circles

Homework, including pre-reading, practices and assessments

Are you willing and able to commit to participating in all program components?

Yes

I would like to have more conversation with you about this

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* 21. Are you holding all the dates (above) in your calendar? Please do!

Yes

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* 22. We recommend that you have a conversation with your supervisor—to explore ways of managing the time commitment of CLA with your other work, and making sure you have their support. Have you spoken to your supervisor and let them know the dates and times that you will be committing to the Community Leadership Accelerator?

Yes

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* 23. Have you spoken to your supervisor about ways of managing the CLA workload and balancing this with your other work commitments?

Yes

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* 24. Do you have your supervisor's support?

Yes

Unsure

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* 25. Do you have any dietary needs that we should be aware of as we plan meals for the in-person retreats?

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* 26. Would you be willing to share a room during the in-person opening and closing retreats? There are a small number of single rooms that will be assigned in order of request. Single rooms increase the cost of the program by $350.

Yes

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* 27. What else, if anything, would you like us to know?

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* 28. The pricing structure is inclusive of all CLA materials, as well as room, board, and food (for the opening and closing retreats):

$6,000: Early bird for smaller organizations (budget under $5m)

$7,000: Early bird for medium organizations (between $5m and $30m)

$6,500: Regular rate smaller org

$7,500: Regular rate medium org

$9,500: Large organizations (over $30 million)

* All rates represent the shared room rate. The cost for single rooms is an additional $350. Single rooms are limited and subject to availability (first come first served).

**Early bird rates apply until January 31.

Select the level that applies to you.

$6,000 Early bird small organization

$7,000 Early bird medium organization

$6,500 Regular rate smaller organization

$7,500 Regular rate medium organization

$9,500 Large organization

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* 29. Please tell us how you will be paying for the program so that we can get an invoice to the right person/people.

My organization will be paying for me

I will be paying for myself

My organization and I will be splitting the cost (please provide instruction in the box below of how it will be split)

I will be applying for a scholarship

A community partner is paying for my participation (please tell us who in the box below).

Please tell us more, if necessary

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* 30. Upon receiving your completed registration survey, we will send an invoice. If the invoice should go to someone in addition to you, please provide their email address here.

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* 31. We understand that this is an investment and have given some time to think of ways to fund participation:

Your organization covers the cost

You share a portion of the cost with your organization

You pay yourself

You raise funds for part of the cost from a funder, donor, or many donors (crowdfund)

We provide some support, when possible

Scholarships may be available and can be requested. If you've already been informed that your organization or a community partner is sponsoring you, you don't need to apply for assistance.

We ask those who need assistance to pay the highest amount you or your organization can reasonably afford. That way we can support others and their needs too.

With that in mind, will you need a scholarship? (The link to the Scholarship Application is on the next page of this application).

Yes

A community partner is sponsoring me

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