• Please submit three (3) stapled sets and one (1) paper-clipped set of the information requested below (Section I – III).
• Please do not exceed the page limit indicated for the nomination letter and resume.
• Submissions should be double-spaced in 12-point font.
• The name of the nominee* should appear in the upper right corner of every page submitted.
• Please submit only one nomination of an individual leader or leadership group per nomination package. If you are submitting more than one nomination, prepare each nomination package separately and mail in separate envelopes.

*Throughout this text, the term “nominee” is used to represent both individual leaders and leadership groups.

Please send the completed nominations package to:

Attn: Nominations
Leadership for a Changing World
Advocacy Institute
1629 K St., NW, Suite 200
Washington, DC 20006-1629

Nominations Must:

• Be signed by the nominator.
• Be received by the Advocacy Institute at the above address by January 7, 2005, 5 p.m. (EST)
• Be complete (see checklist).

I. Nomination Letter
Please address all of the following questions in a combined total of no more than five (5) double-spaced pages. Organize your responses by sections. Use the numbers and letters of each section in your response to identify the question to which you are responding. Sign the letter and provide your title and organization (if any), mailing address, phone, fax, and email address in your letter. Unsigned letters will not be accepted.

1) How did you hear about Leadership for a Changing World? Please provide specific details.

2) Describe the field in which your nominee works in four words or less (e.g., religion and social change, affordable housing, environmental justice).

3) Please address all of the following questions A –D (A–E for leadership group nominations):

A. In what capacity and for how long have you known the nominee?

B. What social problem(s) does your nominee address? How does your nominee work to address them? Describe specific examples of your nominee’s track record.

C. Provide concrete examples that demonstrate the leadership style and characteristics of the nominee.

D. Describe the communities or the constituencies with which your nominee works. How does your nominee engage community members? Give examples of how your nominee’s work bridges boundaries among communities (e.g., geographic, racial/ethnic, issue, etc.)?

E. (For group nominations only) Describe the role of each nominated leader within the leadership group, and tell us how the team works together and shares leadership.

II. One-Page Resume
In addition to professional and volunteer experiences, please include a list of awards received and leadership programs in which the nominee has participated. If this is a group nomination, please submit a resume for each individual within the leadership group.

III. Additional Forms

(Download or Contact the Advocacy Institute for a Brochure)

FORM A. NOMINATOR AND NOMINEE CONTACT INFORMATION AND OPTIONAL DEMOGRAPHIC INFORMATION
If leadership group nomination includes more individuals than the space allows, please photocopy this form and include the additional names and contact information.

FORM B. ORGANIZATIONAL REVENUE INFORMATION

FORM C. REFERENCE CONTACT INFORMATION
List two references who are deeply familiar with the nominee(s)’ leadership style and who have experienced the nominee(s)’ leadership in action. The reference should be able to provide detailed anecdotal information about their leadership. Include their names, affiliations, addresses, telephone and fax numbers and email addresses. In the case of a leadership group nomination, provide two references for the group.

CHECKLIST
In order for nominations to be considered please make sure to follow the guidelines carefully. A complete nomination consists of:

___ Three (3) stapled sets and one (1) paper-clipped set of the following with the name of the nominee appearing in the upper right corner of each page of the nomination letter

___ A signed nomination letter of no more than five double-spaced pages

___ One-page resume

___ Nominee and Nominator Contact Information and Optional Demographic Information (Form A)

___ Organizational Revenue Information (Form B)

___ Reference Contact Information (Form C)

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