Posted in Combating Hate. Glass Leadership Institute 2021-2022 Application September 9, 2021 Glass Leadership Institute Application Form Contact InformationFull Name* First Last Date of Birth* Month Day Year Home Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone:*Email:* Profession / Title:* Company Name:* Business Address:* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Business Phone:*Business Email:* Preferred Email Address:*PersonalBusinessPreferred Phone Number:*PersonalBusinessPreferred Method of Contact:*EmailTextPhoneMailSocial Media(Optional)Facebook Profile URL Twitter Handle URL Other Background InformationAlma Mater(s)* Year(s) of Graduation* Degrees Held* Major / Areas of Study* Please list any boards on which you serve or leadership positions you hold*Other community-based organization affiliations:*Professional/Communal Awards and/or Distinctions you have received:*Please list activities and interests outside of your professional/charitable pursuits:*Have you previously been involved in the ADL? If so, how?*References- Please list one personal and one professional reference*0 of 1000 max charactersEssay QuestionsPlease limit your answers to 300 words for each question1) What interests you most about ADL’s mission and work in the region? Why?*0 of 1000 max characters2) How will your professional and personal experience contribute to the Glass Leadership Institute and ADL in the region?*0 of 1000 max characters3. The ADL Values guide our work every day. The seven ADL Values are: Courage, Respect, Collaboration, Inclusion, Integrity, Credibility, Accountability. Please select one of the values and discuss the role this value plays in your personal or professional life.*0 of 1000 max characters Statement of ExpectationsHaving read the “Statement of Expectations and Responsibilities of the Glass Leadership Institute,” I understand the expectations of the Institute and would like to be considered for the 2024 program year. I understand that ADL may use application information to conduct a background check. I understand that a minimum donation of $250 is mandatory, as is attendance at all sessions, the National Leadership and Never is Now summits and Glass graduation. I understand that failing to fulfill these expectations will result in my removal from the program without reimbursement.* Yes PhoneThis field is for validation purposes and should be left unchanged. Posted in Combating Hate.