Thank you for your interest in the work of Growing Leaders. If you are interested in partnering with Growing Leaders in some way, please complete this form and then send an email to Clari Mercier (clari@growingleaders.com) indicating that you have done so.

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* 1. Contact Information:

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* 2. Does your organization have a website?

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* 3. If your organization is on Social Media, please list the URL addresses for each one below:

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* 4. Are you personally on Social Media? If so, please list your addresses below:

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* 5. Organization Type (Please check all that apply):

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* 6. What is the age range of the students that you serve?

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* 7. What ethnic groups of students do you serve?

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* 8. What is the legal structure of your organization? (Please select one)

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* 9. What are the primary languages you use at this time?

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* 10. What percentage of your organization is focused on developing young leaders?

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* 11. If your focus is less than 100%, what are the other areas of focus?

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* 12. Which of the following best describe your current young leader development initiatives? (Check any that apply, including the percentage of young leaders your organization develops from this methodology)

  Do you focus on? (Yes or No) % of Young Leaders
One-on-one mentoring:
Formal classroom training:
Seminars and workshops:
Larger group events and conferences:
Printed resources for free:
Printed resources for sale:

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* 13. In total, how many different young leaders did you invest in through the above methods in the last year?

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* 14. What printed leadership development resources are you currently using and in what language(s)?

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* 15. What other organizations in your country/region are doing young leader development that you are aware of?

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* 16. Please list their names and websites

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* 17. Do you have a relationship with any other organizations at a national or regional level in your country that would work with you on a comprehensive young leader development strategy?

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* 18. After reading about our philosophy of developing young leaders, how compatible is this with your values and what if any cultural barriers do you foresee?

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* 19. What, if any cultural barriers do you foresee in using our curriculum?

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* 20. What is the annual revenue of your organization in a typical year? (Please indicate currency):

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* 21. How much funding have you allocated towards implementing this program? (Please indicate currency)

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* 22. Have you ever attended any type of Growing Leaders event?

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* 23. If Growing Leaders entered into a partnership with you, please describe how you would use the Habitudes Curriculum. Please include a short project description.

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* 24. Would the Habitudes curriculum need to be translated into a language other than English?

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* 25. Please check the boxes below to note consent to the following guidelines.

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* 26. Are you presently a subscriber to Dr. Tim Elmore’s blog?

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