Application

Social Enterprise Academy application

The full printed application, now online. Everything is submitted in one pass — allow about 30 minutes and have your last three fiscal years of financials to hand.

Prefer paper? Download the PDF version.

Organization

Organization *

Executive Director *

Project Director, if different

Title

Email address *

Mailing address

Office phone

Mobile

Organizational and financial information (past 3 years)

Measure			Current FY (est.)
Operating expense ($)
Net operating income ($)Operating revenue less operating expenses
Paid staff in FTE1 person full time = 1 FTE
Volunteer staffFull & part time

What percentage of annual income from the most recently completed fiscal year came from:

Foundations (%)

Individuals &/or special events (%)

Government (state) (%)

Government (federal) (%)

Earned income — fee for service, product sales, other (%)

About your organization

1. What is your organization’s mission? * (max 100 words)

2. Core services and primary programs * (max 300 words)

3. Target population * (max 150 words)

4. Does your organization have a social enterprise business or activity?

YesNo

Describe the service(s) or product(s), current status, earned income and operating cost for the most recent fiscal year (max 200 words)

5. Why do you want to participate, and why is this a good time? (max 150 words)

6. How much interest and enthusiasm is there among your board and staff? (max 150 words)

7. What metrics and systems do you use to track program impact? (max 200 words)

8. How did you learn about the Academy?

Social Enterprise Academy team

List the three to five members of your leadership and/or staff who will actively participate in every session of the workshop series and the showcase.

Primary contact / team leader

Name

Title / primary function

Length of time at organization

Primary phone number

Primary email address

Team member 2

Name

Title / primary function

Length of time at organization

Team member 3

Name

Title / primary function

Length of time at organization

Team member 4

Name

Title / primary function

Length of time at organization

Commitment and signature

Phase I: workshop series, business feasibility planning. A team of three to five people from our organization will participate in the workshop series and feasibility plan development work, investing 6–8 hours each per month.
Phase II: social enterprise showcase. Drawing on coaching from ASE business mentors, the team will create a presentation describing the venture in terms that make it attractive to potential investors.
Providing financial and program information so sponsors can track the short and long term impact of participating in the Academy for at least three years.

My signature below indicates our organization’s commitment to and understanding of these program requirements. *

Authorized signatory name *

Authorized signatory title

Signature (type your full name) *

Questions? Betsy Densmore, 949-500-2381