Organization

First Name *

Last Name *

Address Line 1 *

Address Line 2

City

Postal Code

EIN Number *

Please enter your Federal EIN number assigned by the IRS. This is a required field so take a moment and locate it before going further.

Phone *

Email *

Website

Budget Size *

Name of Representative completing this form.

What cause does your organization serve? *

In a few words, please tell us what cause or mission your organization serves.

Job Title *

If other than CEO

Enter required value CEO/Executive Director CFO/Finance Other

Full-Time Employees

Part-Time Employees

Supervise staff

Yes No

Professional experience (3500 characters) *

Tell us about yourself: career, community involvement.  Please include volunteering and any board experience. 

List 3 strengths and 3 challenges for you as a nonprofit leader. (1500 characters)

Career accomplishments

Briefly describe your 3 most significant career accomplishments to date. 

Goals - short term

Please share your short-term career goals.

Goals - long term

What are your long term goals?

CEO Circles

What do you hope to achieve by participating in Nonprofits First CEO Circles program?