Facilitate Change

Facilitate Change
APPLICATION GUIDELINES AND INSTRUCTIONS

Please answer the questions in a way that meets your needs for expression, simplicity and clarity. We designed the application to foster connection for us with your vision, intentions and desire about being part of the FC and, we hope, to give you ease in completing it---our sense is that the application (depending how you choose to reply to questions) can be completed within one to two hours.

Email your completed application (in Word please w/your name saved as subject in doc) as an attachment, to info@brooklynnvc.org, with “FC application” in the subject line before February 15, 2008. (If you would like to apply after Feb. 15th, please send a brief note to info@BrooklynNVC.org letting us know of your intention to apply and the date you will submit your application.)

Mail your $100 application fee to Brooklyn NVC, 340 Decatur St, Brooklyn, NY 11233 Attn: FC. Include “Application Fee/FC” in the memo section of your check. You can also make your application fee via by credit card at www.BrooklynNVC.org. Please note that your application fee is deductible from the financial contribution you make for the program. If you are unable to email your application, please mail both the application form and application fee to the above address, Attn: FC Application.

All of our communications about the program are via email, so if you don’t have an email account, please find a friend willing to accept email for you so that you stay connected.

After we’ve had a chance to review your application, we'll be in touch via phone or email regarding any questions we may have and the status of your application.

We look forward to receiving your application and to your hopefully being part of the FC program and community in 09.

Warmly,

The Facilitate Change Team

I. PERSONAL INFORMATION, BACKGROUND & EXPERIENCE

A. Personal Information:

Name:

Email:

Phone - day:

Phone - evening:

Phone - cell:

Address:

City/State/Zip:

Emergency Contact (name and all phone numbers, for retreats):

B. Background:
We believe diversity increases our opportunities to build community and impact the world, so we would like to know how participants identify in the group. Please feel free to skip or add to the following:

Birth place/nationality:
Gender Identity:
“Race"/Heritage/Ethnicity:
Class:
Sexual orientation:
Other:

How did you hear about Facilitate Change?
___ Brooklyn NVC ____ CNVC website
___ Leadership that Works ____ Listserv(s): __________________
___ Flyer or brochure ____ Other (please specify): _____________________

C. Experience with NVC:

Request: Please keep the questions in bold, and reply in plain text to make it easy for us to read your responses.

1. How has NVC impacted your life? Include what excites you about NVC and describe any involvement with an NVC community.

2. Do you have hesitancy or concerns about NVC or joining the Facilitate Change program?

3. What knowledge, passion or skills would you like to share with the Facilitating Change community? How do you see yourself contributing to the program?

4. How do you see the practice of NVC related to social change?

D. NVC Training/Integration/Objectives

1. How many hours of NVC training have you completed? _____ (We would like each participant to have 40+ hours before April 1st, 2009)

2. How long have you been studying NVC or integrating NVC in your life? _____ months

3. Describe your NVC experience, including # of days of workshops or retreats you’ve attended, hours of practice group sessions, telephone-based training, trainers you have worked with, books you’ve read or CDs you’ve listened to:

Title/Training: Trainer/Material:

4. What do you consider your current NVC “learning curve” (what you find challenging in and/or would like to further develop in yourself and your NVC practice?)

5. How would you describe your level of integration of NVC consciousness and skills, with 1 = Great challenge and 5 = Great ease? Please feel free to share any comments:

6. Are you a Certified Trainer and/or do you intend to pursue CNVC certification?

__ I have been certified since: _______
__ I am pursuing certification and anticipate completing the process in _______ months
__ I am intending to pursue certification & to begin the process in ______ months
__ I do not currently plan to pursue certification
__ I am undecided

E. Social Change Experience/Interests:
1. Describe any social change experience you’re engaged in now or in the past. Briefly describe any social change organizations you’ve worked with, volunteering, causes, leadership positions, areas of service, community involvement:

a. Please list all areas of social change that interest you:

b. Is there a particular social change project or initiative that you would like to focus on during the Facilitating Change program? If so, describe:

c. What is your vision for the world? How do you see yourself contributing to creating this world and your vision manifesting?

II. INTENTIONS IN JOINING THE FACILITATE CHANGE COMMUNITY

A. Why are you applying to Facilitating Change? (Include in your answer how you will use what you gain from this year in the future).

B. Will you be able to participate fully in all program components (social change project, all three retreats, Tele-classes, empathy groups and written assignments)?

__ Yes __ No __ Unsure

C. Will you be able to set aside 3-8 hours a week (more or less) for your project, empathy groups, teleclasses, and other opportunities for building community and implementing social change?

__ Yes __ No __ Unsure

D. Is there anything else you would like us to know?

E. Do you have any requests of us at this time?

III. ABOUT MONEY

A. Financial Exchange for the Program:
The financial exchange for the FC is on a sliding scale of $2,750 -$4,750 for the nine month program. The top of the scale ($4750) approaches what is sustainable for us to create and continue the FC. We ask you to support FC and its vision by contributing as close to the top of the scale as you joyfully can. In doing so, we invite you to connect with your own values (we imagine for peace making, mutuality, and community) and the value and power of this work to transform the world.

Wanting to include as many who want to participate in the FC as possible, we offer the FC program on a sliding scale. Valuing inter-dependence and community, we encourage you to consider all the individuals, groups, and organizations that you will impact and contribute to via your being part of the FC program. We would love for you to invite these family, friends, colleagues, and employers to support you in participating in Facilitate Change and for you to think creatively about how you can generate the resources you'd like to participate in the program, such as via requesting monthly donations from supporters, air miles, pledges, etc.

Please also note that the program fee can be broken up over in a payment plan and/or that your financial contribution can be made via credit card, if this supports your participating. See details below.

On the sliding scale of $2,750-$4750, I will be contributing $________ as a financial exchange for the program fee.

B. Facility Fees:

In addition to financial exchange for the program fee, there is a facility fee, including room and meals, of $375 per retreat. Camping, bed-rolling or commuting is $225 per retreat, including meals.

I am intending to (check one): ________ stay on site ______commute/bed-roll/camp.

C. Payment Option for Program Fee (please check and complete all that apply):

____ I will be making payment in full on acceptance to the program or by March 1, 2009. (Note: This option gives us ease in administration and supports effective use of our resources)

____I will be making use of a Payment Plan. This plan includes a Deposit of 40% _________ due March 1, plus three monthly payments of 20% each $_____ due on May 1, June 1, and July 1 via post-dated checks. (Note: If you are choosing this option, please request a copy of our Payment Plan Agreement and return this with your application).

___I will be paying all or in part via credit card (note: this involves our paying approximately 4% of your contribution in credit card fees).

___ I understand that in addition to the above agreement for the program fee that the Facilities Fee is due two weeks before each retreat (of $375 or $225 per retreat, depending on option I choose).

NOTE: All payments for program and facility fees are made payable to Brooklyn NVC, 340 Decatur Street, Brooklyn, NY 11233. Please note "FC" in memo line of your check and if payment is for program or facility fee.

IV SUPPORTING THE FC PROGRAM
We would appreciate your support in sustaining the FC program!

A. Are you able and willing to contribute your time to support the FC program?
____YES ____NO

If yes:

B. What skills might you be able to offer Facilitate Change?

C. How much time (per week or per month) would you have available to contribute to supporting the Facilitate Change program/community and for how long (which portion of the year)?

D. Are there any groups or organizations that you'd be willing to contact about the FC program?

Thank you for completing this application and for your interest in the Facilitating Change program and creating a world where the needs of all life are held with care!