ACHARAI Fellows Program Nomination Form

Nominating Organization*
Contact Information

Please include for each sponsor below.
First Name*
Last Name*
Title
Address*
Street Address Address Line 2 City State ZIP Code
Email*
Phone*
Name of Nominee*
Current Organizational Leadership Title
Please describe the nominee's current responsibilities.
List the future leadership role(s) for which the nominee is being considered. Be specific to the timeline of when the nominee is expected to assume the top leadership position of your organization. If not sure, please explain.
Have you discussed with the nominee succession into a top leadership position? Is the nominee willing to commit to stay through service as the top leader to your organization following participation in the AFP?
Please describe the size and structure of your organization and governing body.
Please explain the priorities of your organization and how the nominee will help your organization in the future.
Make a case as to how, specifically, you see the ACHARAI program helping the nominee.
What are the distinguishing qualities or characteristics that make your nominee appropriate for this program?
Sponsor Signatures

We pledge that the program fee of $1800 will be paid to ACHARAI by June 30, 2022
Name*
Date*
MM slash DD slash YYYY