2027 Program Application

Each year leaders from all sectors and backgrounds in the Greater Hartford community are selected for the Quest program. Participants will build leadership skills, knowledge and network for effective leadership within their organizations and communities.

First Name *

Last Name *

Preferred Name

Job Title *

Company/Organization *

Work Phone *

Phone Type (select work)

Work Email *

Address

City

State/Province

Zip

Home Address

Apt#

Home City

Home State

Home Zip

Home/Cell Phone *

Phone Type (select home or cell)

Personal Email *

Preferred Contact *

Work
Home

Referred to the Quest program by

Describe your current employment position and responsibilities

Please indicate your company's budget size

Nonprofit / Government Entities

For-Profit Companies

My supervisor has approved my application *

Yes
No

List any current affiliations and community involvement. Ex. Board/Commission/Council/Association/Committee/Task-force/Membership, etc.

What do you expect to gain from participating in this program?

Periodic reporting on demographics, along with other information, is provided to our funders to evaluate the impact of our programs in the communities we serve. Please kindly provide the following information:

Gender Identity

Birth Date

// (mm/dd/yyyy)

Marital Status

Race/Ethnicity

Income

Education

Attendance: Monthly program sessions are held on Thursdays at varying times in-person (virtual/hybrid programming available if necessary), unless otherwise specified. Participants are expected to attend these mandatory sessions. In addition, participants are expected to work in a learning circle designed to better understand the opportunities and challenges facing our region. Optional sessions will be offered. We estimate learning circle activities may require approximately two-to-six additional hours each month beyond the scheduled monthly sessions. Participants are expected to attend a minimum of 85% of the program sessions and 85% of the learning circle meetings. I have read and understand the responsibilities as described above:

I agree
I do not agree

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