DignityUSA Leadership Academy Application

December 3, 2021

by

Marianne Duddy-Burke (she/her)

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 alt=></p><h1></h1><h1></h1><h1></h1><h1><span><i>Leadership Academy Application</i></span></h1><p><span>&nbsp;</span></p><p>Please complete and submit this form and a narrative of maximum 2-page length.</p><p>Return to Daniel Barutta at&nbsp;<a href=mailto:dbarutta@gmail.com>dbarutta@gmail.com</a>.</p><p>&nbsp;</p><p><strong>Application deadline: &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Friday March 18 2022.&nbsp;</strong></p><p><strong>Notification:&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;Selectees will be notified in April.</strong></p><p>&nbsp;</p><p>Name:&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ___________________________________________</p><p>Pronouns: &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; ___________________________________________</p><p>&nbsp;</p><p>Email:&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;___________________________________________</p><p>Phone/Cell: &nbsp;&nbsp;&nbsp; ____________________________________________</p><p>&nbsp;</p><p>Who could tell us more about your leadership aspirations or experiences? (Name/email or cell)</p><p>Person 1:&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; ____________________________________________</p><p>Person 2:&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; ____________________________________________</p><p>&nbsp;</p><p>Please submit a narrative describing yourself and your motivations to be a participant in the Leadership Academy. We encourage you to address the following topics. &nbsp;</p><p>&nbsp;</p><p>Describe your current participation in Dignity either at the local chapter/community level the national level and as a national member.</p><p>&nbsp;</p><p>What motivates you to become a leader? Since many people are leaders and may not realize it yet can you think of any examples in your life where in fact you have led or do lead people?</p><p>&nbsp;</p><p>What kind of leadership skills would you like to gain or improve?&nbsp;Consider topics such as your goals in life your spirituality what really motivates you interesting aspects of your life such as hobbies community involvement and more.&nbsp;</p><p>&nbsp;</p><p>Describe an experience with someone whose life experience is different than your own.</p><p>&nbsp;</p><p>Please feel free to provide anything you would like us to know about you.</p><p><i>&nbsp;</i></p><p><i>Thank you! Questions? Contact Daniel Barutta: 202-607-8722;&nbsp;<a href=mailto:dbarutta@gmail.com>dbarutta@gmail.com</a>.</i></p><p>&nbsp;</p>