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Thank you for your interest in participating in the third annual Collaboration Lab cohort!  Please fill out this short survey to apply for the program. Applications will be accepted through August 25. Participants will be notified by September 1.  If you would prefer to share your responses in another format, such as by phone or video, please contact Annie Martinie at amartinie@drfonline.org or 434-799-4545. 

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* 1. Name

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* 2. Organization Name (if applicable)

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* 3. Phone Number

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* 4. Email address

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* 5. Where do you live?

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* 6. Please select the localities that you serve through your work or volunteer role. Check all that apply. 

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* 7. Collaboration Lab will provide an opportunity for each participant to enhance a current collaboration or begin a new collaboration. Please describe an existing collaborative effort that you are interested in enhancing or a new collaboration that you may be interested in exploring.

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* 8. Please briefly describe one success and one challenge you have experienced in leading or participating in a collaboration or collaborative project? 

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* 9. Collaboration Lab is designed to help participants enhance their ability to lead in a collaborative way. Think about a collaborative leader that you admire and describe the characteristics or skills that make that person a strong leader. Which of these characteristics would you like to activate in yourself through this program?

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* 10. If you are selected, tell us which of these topics you would like to learn more about. Please rank the options based on its importance to you. 

  1. Conflict resolution 
  2. Facilitation 
  3. Engaging diverse community members
  4. Asking powerful questions
  5. Knowing when to assert and when to engage
  6. Creating and unifying around a shared vision 
  7. Building trust and sharing power
  8. Evaluating collaborative projects
  9. Creating an open and credible process
  10. Activating leadership within others
  11. Developing strategies that are community-centered and adaptive 

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* 11. Collaboration Lab will include both in-person and virtual sessions. Do you have reliable internet access and a computer or tablet? If your is answer no, we will contact you to discuss options. 

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* 12. Are you able to commit to attending all 10 Collaboration Lab sessions (September 2022 - June 2023) on the second Tuesday of each month from 9am to 1pm?

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* 13. If selected, would you be able to submit a letter of support from your supervisor or organizational lead to participate in Collaboration Lab (if applicable)?

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