City Scholars® Fellowship for Education NOMINATION Form - 2023

**PLEASE review the Fellowship for Education Nomination + Selection FAQs, posted on our website, before completing your nomination.**

**PLEASE note that you must complete your nomination in one sitting. You cannot save and finish later. Moreover, once submitted, you cannot edit your nomination.**

To all Nominators:

At City Scholars^® Foundation, we educate and empower nonprofit CEOs to lead well with limited resources and work collaboratively to build more effective organizations that help thousands of low-income youth achieve against the odds. To fulfill our mission, we sponsor our City Scholars^® Fellowship for Education.

As a unique partnership, tuition-free learning community and resource network, our City Scholars^® Fellowship for Education is more than a one-time training experience. Partnering with executive volunteers, our Fellowship helps extraordinarily collaborative nonprofit CEOs, who are distinguished as City Scholars^® Foundation Fellows, to build essential business and leadership skills, confidence and connections to grow after-school and school-based nonprofits from survival to success to significance.

Thank you for helping us make our mission possible by nominating an exceptional nonprofit CEO as a prospective Foundation Fellow. Nominations are not a guarantee of admission, but rather an opportunity for us to get to know passionate leaders throughout the greater Southern California region.

If you wish to nominate multiple leaders, please submit a separate nomination for each leader. If you have any questions, please contact us at 213-627-1792 or at fellowship@cityscholars.org.

NOMINATOR INFORMATION (Tell us about yourself.)

Question Title

* 1. Nominator Contact Information:

Nominator First Name

Nominator Last Name

Nominator Title

Nominator Company/Organization

Organization Address

Organization City

Organization State

Organization Zip

Nominator Company/Organization Website

Nominator Email

Nominator Linked-in Profile (if none, please respond "N/A")

Nominator Office Phone Number

Nominator Mobile Phone Number (if none, please respond "N/A")

Question Title

* 2. Do you have any association with City Scholars^® Foundation?

Yes

If you answered yes, please specify:

NOMINEE Information (Tell us about your nominee.)

Question Title

* 3. Nominee Contact Information:

Nominee First Name

Nominee Last Name

Nominee Title

Nominee Nonprofit Organization

Organization Address

Organization City

Organization State

Organization Zip Code

Nominee Nonprofit Organization Website

Nominee Email

Nominee Linked-in Profile (if none, please respond "N/A")

Nominee Office Phone Number

Nominee Mobile Phone Number (if none, please respond "N/A")

Question Title

* 4. Nominee Age Group

20-29

30-39

40-49

50-59

60-69

70+

Question Title

* 5. Nominee Ethnicity

American Indian or Alaska Native

Asian

Black or African American

Hispanic or Latino

Native Hawaiian or Pacific Islander

White or Caucasian

Multiracial

Question Title

* 6. What is your relationship to your Nominee?

Question Title

* 7. How long have you known your Nominee?

< less than one year

1 - 3 years

3 - 5 years

5 - 7 years

7 years+

Question Title

* 8. Can you affirm that your nominee has reviewed the First-Year Foundation Fellow Leadership Pledge?

Yes

Comment(s)

Question Title

* 9. How confident are you that, if selected, your nominee is ready, willing and able to fulfill the First-Year Foundation Fellow Leadership Pledge?

Very Confident

Confident

Somewhat Confident

Not Confident

Comment:

Question Title

* 10. Based upon your review of our Fellowship selection criteria, why do you believe your nominee would make an excellent City Scholars^®Foundation Fellow, if selected?

Question Title

* 1. Nominator Contact Information:

Question Title

* 2. Do you have any association with City Scholars® Foundation?

Question Title

* 3. Nominee Contact Information:

Question Title

* 4. Nominee Age Group

Question Title

* 5. Nominee Ethnicity

Question Title

* 6. What is your relationship to your Nominee?

Question Title

* 7. How long have you known your Nominee?

Question Title

* 8. Can you affirm that your nominee has reviewed the First-Year Foundation Fellow Leadership Pledge?

Question Title

* 9. How confident are you that, if selected, your nominee is ready, willing and able to fulfill the First-Year Foundation Fellow Leadership Pledge?

Question Title

* 10. Based upon your review of our Fellowship selection criteria, why do you believe your nominee would make an excellent City Scholars® Foundation Fellow, if selected?

* 2. Do you have any association with City Scholars^® Foundation?

* 10. Based upon your review of our Fellowship selection criteria, why do you believe your nominee would make an excellent City Scholars^®Foundation Fellow, if selected?