Social Enterprise Application Question Title * 1. Are you a leader in a non-profit organization? OK Question Title * 2. Briefly describe your familiarity with Social Enterprise. OK Question Title * 3. Have you already considered how to incorporate Social Enterprise into your non-profit practice? Yes No OK Question Title * 4. Briefly describe how you see social enterprise impacting your non-profit practice. OK Please Rank your organization on the scale below by circling the number closest to where your organization falls. OK Question Title * 5. Describe Your Agency Leadership. Insular Leadership Neutral Inclusive Leadership Insular Leadership Neutral Inclusive Leadership OK Question Title * 6. Describe Your Agency's Culture. Traditional Culture Neutral Innovative Culture Traditional Culture Neutral Innovative Culture OK Question Title * 7. Describe Your Relationship with the Community. Agency-Focused Neautral Collaborative & Community-enganged Agency-Focused Neautral Collaborative & Community-enganged OK Question Title * 8. Describe Your Agencies Buy-in to Social Enterprise Organization has not yet bought into Social Enterprise Neutral Organization has bought into Social Enterprise Organization has not yet bought into Social Enterprise Neutral Organization has bought into Social Enterprise OK Question Title * 9. Thank You For Taking Time To Fill Out This Application, Please Fill In The Information Below and We Will Be In Contact With You Soon. Name Company Address Address 2 City/Town State/Province ZIP/Postal Code Country Email Address Phone Number OK DONE