2020 David Bohnett LGBTQ Leaders Application

Designed for all senior-level executives working with state and local governments - including government officials and elected office holders - this intensive, three-week Executive Education program at the Harvard Kennedy School in Cambridge, Massachusetts, hones skills and furthers the leadership potential of accomplished individuals from across the United States.

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Contact Information
Name*
First Last
Email*
Please confirm*
- YES, I have submitted my application to the Harvard Kennedy School and indicated "Bohnett" as my financial sponsor.
- NO, I have not yet submitted my application but will email [email protected] to confirm when I have submitted it.
Home Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

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Demographic Information
Date of Birth*
MM/DD/YEAR
Race/Ethnicity*
Sexual Orientation*
Gender/Gender Identity*
Pronouns*
Political Affiliation*

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Funding
The Victory Institute generally attempts to cover more than one-half of the approximately $12,400 Harvard Kennedy School Program fee which covers tuition, housing, curricular materials, and most meals. Successful applicants typically demonstrate a plan to cover at least $5,000 of expenses, although exceptions are made occasionally for those who demonstrate financial need. Fellows are required to attend the International LGBTQ Leaders Conference and to pay for their own travel, hotel and registration happening in December 2020.Examples of funding include (a) professional development funds from your budget, (b) grants from nonprofit foundations in your city/state, (c) fundraising from individual donors, (d) other fellowship opportunities listed on the HKS website, and (e) self-funding.
Please list your potential or secured sources of funding in separate lines, including the amount with each source. Include any self-funding on a separate line.*
If needed, please explain your financial need.

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Confirmation
Please initial to indicate your agreement with the following statements:
I understand that if I am selected as a David Bohnett LGBTQ Leadership Fellow, personally identifiable information including my name and title will be released to the public, such as through blog posts on the web and newsletter announcements.*
I understand that this is a full-time executive education program running for three weeks in June or July. I will fully participate in the program, including any Victory sponsored activities, immediately before, during, and immediately after the Harvard Kennedy School program.*
I understand that I am required to attend the International LGBTQ Leaders Conference December 2-5, 2020 and to pay for my travel, hotel and registration. I will be eligible for a discounted registration fee as an alum of the program.*
I understand that I will receive email communications from the Victory Fund and Institute and that I may unsubscribe from these emails at any time.*
Date*
Date Format: MM slash DD slash YYYY
I acknowledge that I have read and understand all of the eligibility and application requirements, have completed the application truthfully, and consent to submitting this application electronically.*

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2020 David Bohnett LGBTQ Leaders Application

2020 David Bohnett LGBTQ Leaders Application

Step 1 of 5

Contact Information

Demographic Information

Credentials

Funding

Confirmation