Thank you for your interest in the Executive Leadership track at the AHP Madison Institute. This track is designed for chief philanthropy executives and those who have been identified in a succession plan as the "next in line" for the CPO role. If you are not currently a chief philanthropy executive, admission to the track is on a case-by-case basis. Your track faculty ask that you fill out this application form to share more information about your role and how this track can benefit you.

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* 1. Please provide the below information:

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* 2. Please provide details about your reporting structure below. Who do you report to (CEO/EVP/Board, etc.)?

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* 3. May AHP or Executive Leadership faculty members contact your immediate supervisor? If yes, please provide their contact information below.

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* 4. Please describe your current organization in a few sentences (e.g. size of foundation staff, part of a system or standalone entity, total annual fundraising revenue, etc.).

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* 5. Please provide a description of your current role.

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* 6. Why do you feel the Executive Leadership track is the right track for you? What do you hope to gain by participating in this learning experience? And why now?

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* 7. Please include a letter of recommendation from your immediate supervisor, AHP Leadership, or another Chief Philanthropy Officer. You may either attach the letter here or email it to education@ahp.org after submitting this application.

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* 8. What are your healthcare philanthropy superpowers (areas in which are you most proficient and could offer insight to your fellow participants)?

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* 9. Thinking as a leader, what concern do you feel is the biggest challenge that your shop faces today?

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