Black Defender Leadership Institute 2.0 Question Title * 1. First Name Question Title * 2. Last Name Question Title * 3. Pronouns Question Title * 4. Are you a member of BPDA (membership is required to participate in BDLI 2.0) Yes No I'm not sure Question Title * 5. Preferred email Question Title * 6. Mailing address Question Title * 7. What is your race? Asian Black or African American Middle Eastern or North African Hispanic or Latino Multiracial or Multiethnic Native American or Alaskan Native White Native Hawaiian or other Pacific Islander Another race or ethnicity, please describe below Question Title * 8. What is your organization's name? Question Title * 9. Who is your Executive Director Question Title * 10. What is our title in your organization? Question Title * 11. Does your organization serve an indigent/marginalized population(s) Yes No I'm not sure Question Title * 12. Does your office provide any training related to race and/or bias? Yes No I'm not sure Question Title * 13. If yes, please describe. Question Title * 14. How many people work at your organization? 0-10 11-20 21-30 more than 30 Question Title * 15. How many BIPOC hold leadership position(s) at your office? Question Title * 16. Have you ever applied for a leadership position within your office? Yes No Question Title * 17. If accepted in BDLI 2.0 what is the leadership goal/project that you want to work on during your time in the institute. 500 word limit Question Title * 18. How is your leadership goal/project related to the six core competencies of transformational leadership? Question Title * 19. Are you open to receiving feedback from your trainers and/or cohort concerning your leadership goal/project? Question Title * 20. What challenges do you anticipate in accomplishing your leadership goal project? Question Title * 21. What specifically do you hope to learn or gain by participating in BDLI 2.0? Question Title * 22. In BDLI 2.0, each participant will be partnered with a mentor to help with your leadership goal/project. What do you need from your mentor to accomplish your leadership goal? Question Title * 23. Do you know of someone who you believe can mentor and help you achieve your Leadership Goal/Project? Question Title * 24. Are you able to fully commit to all the participation requirements which include 10 hours a month? Yes No I'm not sure Question Title * 25. How will you make time in your schedule to fully participate in programming? Question Title * 26. If accepted in BLDI 2.0, do you believe your office will support your participation? If so, how? Question Title * 27. Please submit a headshot PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only. Choose File Choose File No file chosen Remove File Please submit a headshot Question Title * 28. Please submit a one paragraph bio PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only. Choose File Choose File No file chosen Remove File Please submit a one paragraph bio Question Title * 29. Please submit your resume PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only. Choose File Choose File No file chosen Remove File Please submit your resume Question Title * 30. How did you hear about BDLI 2.0 Facebook Twitter LinedIn BPDA website Word of mouth Other (please specify) Question Title * 31. Thank you for applying to the BDLI 1.0. We are excited to review your application. If you have any questions please feel free to contact us at <info@blackdefender.org> Done