Program Information About the Program Centra is defined as the solid, central parts of vertebras, to which the arches and processes are attached. Women have long been the backbone of rural communities across Montana. They innately have a drive to build community spirit and drive rural development. Montana Farmers Union believes in developing the skills of the impassioned women that lead rural initiatives. The Centra Women s Leadership Program is designed as a two year cohort where participants are guided by their peer mentors in the first year, learning necessary skills in three areas Communication, Issues and Solutions, and Personal and Professional Development. When participants graduate the first year, they then serve as mentors for the first year group. Five to six women will be chosen to participate each year. Program Dates & Expectations The cohort will meet four times per year around the state of Montana. Applicants should be sure that they can commit to the entire two years as well as attend all sessions. Please consider this commitment before applying. The dates for the 2016-2017 program year are listed below. Dates Location Focus May 14-15 Missoula Orientation August 20-21 Billings Communication October 21-22 Great Falls Issues & Solutions (Annual Convention) February 10-12 Chico Hot Springs (Women s Conference) Personal & Professional Development MFU will provide mileage reimbursement, lodging and meals for participation in program dates. Requirements Must be a current MFU member ($50 annually) A one-time participation fee of $100 per accepted applicant due at the time of application. Participation fees will be returned to those candidates not selected for participation. Must be available for all scheduled program dates. Centra Program Application Page 1
Application Complete this application form and send it to : Montana Farmers Union, attn: Delisa Protsman, PO Box 2447, Great Falls, MT 59403 prior to the deadline of April 15 th. Selection will take place and successful candidates will be notified on May 1 st with a potential program start date of May 15 th. If you are not selected for the program, your application will be retained by the committee for consideration of later enrollment. Prior to applying, please ensure that you can make yourself available for all scheduled meeting dates. Attendance and participation are essential to the success of the leadership program. Please direct any questions about the program to Delisa Protsman, Education Director, at dprotsman@montanafarmersunion.com Personal Information Full Name: Informal Name Home Birthdate Mobile Emergency Contact Name Relationship Emergency Contact Professional Information Job Title Company/Organization Business Address Centra Program Application Page 2
Special Honors and Awards Please list any special honors, awards or recognitions you have received for either professional or volunteer activities. Volunteer Information Please list your involvement in organizations for which you volunteer your time. References Three references are required in support of your application. Short Essays What do you hope to achieve by participating in this program? In what ways do you believe the program can be most useful for you? Please explain 1-2 areas of development that you hope to address through participating in this program. Please provide a minimum of 4-5 sentences in your response so that the review committee has a clear sense of your goals. Centra Program Application Page 3
As we look to bring together a diverse group of women, please comment on 2-3 unique strengths/experiences or perspectives that you would bring to the program. What do you consider to be your most significant personal and professional development needs, areas in which you would most like to improve? What would you consider to be most formidable challenge(s) facing rural Montana today? How much time each month do you customarily commit to community, civic, professional, and other organizations and activities? If not, what have been major barriers to your becoming involved? If not, what conditions have changed that now enables you to get more involved? What do you feel have been your most substantial contributions to your community? Centra Program Application Page 4
Program Commitment Your commitment to this exciting leadership opportunity involves mandatory participation on the following dates: Dates Location Focus May 14-15 Missoula Orientation August 20-21 Billings Communication October 21-22 Great Falls Issues & Solutions (Annual Convention) February 10-12 Chico Hot Springs (Women s Conference) Personal & Professional Development I understand and agree to the attendance requirements listed above. Signature Date Demographic Information How did you learn about this program? Check all that apply Direct mail Social Media Committee Member Website TV Advertisement Online Advertisement Email Notification Internet Search Internet Search Print Advertisement Other (please list) What race do you most identify with? African American Asian American Caucasian Native American Other Hispanic Non Hispanic Montana Farmers Union is governed by a set of community values that foster honesty, respect for others, and accountability for one s actions. In accordance with MFU policy, Montana Farmers Union does not discriminate against any person on the basis of race, color, sex or sexual orientation, gender identity, religion, age, national or ethnic origin. Political beliefs, veteran status, or disability in admission to, access to, treatment in, or employment in its programs and activities. I hereby certify that the information provided herein is complete and accurate. I understand that if I give false information, if I fail to attend the opening session and/or scheduled events, or if I fail to meet any part of the obligation for participating, I may be asked to withdraw from the program. Signature Date Printed Name Centra Program Application Page 5