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The University of Chicago: Graduate Studies
Referral for University of Chicago Civic Leadership Academy
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Please complete the first half of this form with your own information.
First Name
Last Name
Title
Organization
Email Address
Country
City
Region
Postal Code
The Civic Leadership Academy (CLA) is accepting referrals for prospective fellows, as well as organizations, colleagues, or other partners you believe may be helpful in connecting us with prospective fellows. Please complete the remainder of this form with the information of the prospective fellow or organization/colleague/partner you would like to recommend.
In order to be eligible for CLA, an individual must be a full-time employee of a Chicago non-profit, the City of Chicago or Cook County. Does the individual you are referring meet this criterion?
Yes
No
Are you affiliated with the University of Chicago?
Yes
No
What is your affiliation?”
CLA Advisory Council
CLA Alumni
Faculty
Staff
Other
Cohort Year
2015
2016
2017
2018
2019
2020
2021
2022
2023
Are you referring a prospective fellow or organization?
Are you referring a prospective fellow or organization?
Prospective Fellow
Organization/Colleague/Partner
First Name of Applicant
Last Name of Applicant
Email Address
Organization
Title
How do you know the applicant?
Comments
Name of organization:
Contact name at organization:
Phone or email of contact:
How do you believe this person or organization can be helpful?
I agree to receive electronic communications from the University of Chicago. I understand that I may unsubscribe at any time.
Submit