NAME
last
first
middle
NAME YOU LIKE TO BE CALLED
ADDRESS
P.O. box and street address
town
county
state
zip
country
place of birth
Telephone (home) (work)
Fax
E-Mail
To the Candidate:
The Rural Development Leadership Network is a national multicultural organization
supporting community-based development in poor rural areas, primarity those
with concentrations of people of color. RDLN builds the capacity of these
areas by strengthening the development of men and women in these communities.
RDLN provides a mechanism for the transfer of knowledge and expertise and
arranges a variety of relationships and opportunities to achieve this goal.
All participants undertake an RDLN Field Project, engage in structured
learning, and convene with other RDLN participants in a Rural Development
Institute. Involvement in RDLN leads to the long-term improvement of your
community and of yourself as an effective rural development worker.
The RDLN Field Project is a hands-on development project in the Leader's
home community. Planning, research and advocacy projects may be included.
There should be clear evidence of need for this Project, support for it
by those affected, indication of resources available toward its implementation
and continuance, and evidence of careful thinking as to its feasibility
and the specific tasks involved in implementation. Projects which can serve
as models for other rural communities are particularly invited.
It is our goal to arrange Study for participants that will support their
RDLN Field Projects, enhance their long-term effectiveness as rural community
development workers, and increase their awareness of rural development
contexts and strategies nationwide. Currently RDLN Leaders may earn a master's
degree or bachelor's degree through external programs which enable them
to continue their community work. Those not choosing to pursue a degree
may earn an RDLN certificate. RDLN Leaders design much of their own study
programs, with the guidance of qualified advisors. They may choose to learn
research skills, business development, economic development, law, governance,
management skills, analysis of community dynamics and potential, methods
of acquiring resources, as well as specific program areas.
The duration of the program is a minimum of eighteen months, and generally
RDLN Leaders are involved for approximately three years. The RDLN Institute
is planned for 4-5 weeks of that time.
RDLN requires logistical and financial support from Sponsoring Organizations
to help defray the cost of each Leader's participation. This includes payment
for living expenses, which may be in the form of an in-kind contribution.
If savings or family resources are available, you may participate.
We look forward to hearing about your rural development plans.
I. CANDIDATE'S BACKGROUND
Date of Birth
Social
Security No.
Marital Status
Ethnicity
Sex
Names and Ages of Children, if any
Do they live with you? Yes No Sometimes
What is the status of your health?
Do you have any physical handicaps?
If so, please describe:
Have you been in the military? Yes
No
If so, during what period of time?
Service Branch:
Rank:
Responsibilities:
Type of Discharge
What is the last grade you completed in school?
What is the name of the last school you attended?
Dates of Attendance
Did you graduate?
Was a degree or certificate awarded?
If so, what one?
If you attended college and/or graduate school, what were your major and
minor areas of study?
Major
Minor
School
Dates
of Attendance
School
Dates
of Attendance
School
Dates of Attendance
School
Dates of Attendance
School
Dates of Attendance
School
Dates of Attendance
What special training have you received, if any? Please describe content,
provider of the training, duration and dates.
Have you ever held public office, or run for public office? If so, please
identify the position, dates and responsibilities.
Are you a member, affiliate or office holder in any organizations? If so,
please describe and provide dates.
What awards have you received, if any?
Please attach your resume to this page.
Are you currently employed?
Please list your most recent jobs, beginning with the most recent.
Employer Phone
Address Name of Supervisor
Employment DatesSupervisor's
Title
Your Title Salary
Responsibilities:
Reason for Leaving:
Employer Phone
Address Name of Supervisor
Employment DatesSupervisor's
Title
Your Title Salary
Responsibilities:
Reason for Leaving:
Employer Phone
Address Name of Supervisor
Employment DatesSupervisor's
Title
Your Title Salary
Responsibilities:
Reason for Leaving:
______________________________________ __________________
Employer Phone
Address Name of Supervisor
Employment DatesSupervisor's
Title
Your Title Salary
Responsibilities:
Reason for Leaving:
7.
Previous Experience in Rural Community Development. What
aspects of your life experience, employment, civic or volunteer work, education
or special training have prepared and motivated you for effective work
in rural community development? Please limit your answer to 500 words or
less.
Personal resources needed for more effective future work in rural community
development (e.g., expertise in certain fields, exposure to certain
kinds of organizations, access to resources, contacts in certain fields,
education, experience, credentials). Please answer in the space provided
on this page.
Please note your preferences for RDLN study:
Bachelor's degree program
Master's degree program
Ph.D. program
Certificate program U.S. International
At home Within 100 miles of home
Within home region (South, Midwest, etc.)
At a central location with participants from other regions
What are the reasons for your preferences?
If you plan to participate in the master's or Ph.D. degree program, please
attach a one-two page outline describing your proposed Study Plan.
II. COMMUNITY BACKGROUND
What is the rural area or areas that you consider the focus of your future
work in rural community development? (If your rural development concerns
cross geographical lines, please state this and adjust your answers accordingly.)
Name:
Location:
Geographical Category (town, county, region, reservation, country, etc.):
Major Population Groups:
Major Economic Activity:
Who are the poor people here?:
Percentage in population:
Sources of income:
Major problems and issues:
Major obstacles to development of community:
Major resources and potential strengths for development of community:
III. RDLN FIELD PROJECT
Please describe a concrete project you would like to undertake during your
participation in RDLN. This may be planning, action, policy development
or a strategic internship assignment. Describe the need for the project,
evidence of community support, duration, concrete steps needed for implementation,
and the contribution the project will make to the community and to your
own development. Please limit this section to 500-900 words.
Please list three people you have asked for recommendations. At least two
of these should also be able to comment on the validity of your proposed
RDLN Field Project. Use the forms provided with this application.
Name
Title and Organization Telephone:
Address
How do you know this person?
_____________________________________
Name
Title and Organization Telephone
Address
How do you know this person?
Name
Title and Organization Telephone
Address
How do you know this person?
The Application
In completing the application, please be as accurate as possible. We may
ask you for additional information at a later date. If you are unsure of
answers to some of the questions, such as what kind of study you would
like to do or where your RDLN Field Project can best be implemented, please
indicate this. RDLN will work with you to arrange the most satisfactory
situation possible.
Please type the application and put your name on every page. Be sure to
keep a copy for your records. Send the completed application to:
Rural Development Leadership Network
P.O. Box 98
Prince Street Station
New York, NY 10012
(212) 777-9137/Fax (212) 477-0367
Feel free to call or write if you have any questions or want to discuss
the program.
Attach application fee of twenty-five dollars ($25.00)
Agreement with RDLN
Philosophy: RDLN supports community-based development and coalition building
among those of different backgrounds working to overcome poverty.
Please sign below to certify that the statements in your application are
accurate, that they may be used for publicity or fundraising purposes by
the program if you are accepted, that you will participate in the program
if accepted and not undertake conflicting work during that time, that your
behavior will be consistent with the RDLN philosophy, that you will provide
written and oral reports to our office as requested, and that you understand
that your involvement may be terminated for unsatisfactory performance
or lack of funds.
RDLN Candidate (signed)
(date)
RURAL DEVELOPMENT LEADERSHIP NETWORK
Recommendation Form
Rural Development Leadership Network
P.O. Box 98
Prince Street Station
New York, NY 10012
(212) 777-9137/Fax (212) 477-0367
Name of Candidate
Address of Candidate
Nature of RDLN Field Project
To the Recommender The above person is an applicant to the Rural Development
Leadership Network. We would be grateful for your assessment of this individual
as a past, present and future worker in the field of rural community development.
Through the program, participants implement an RDLN Field Project, take
part in structured study, and convene with other partici-pants in a month-long
RDLN Institute. We are looking for people of good character, strong commitment
to rural community development, ability to make a long-range contribution
to the development of their home community or to rural community development
more generally and those who have proposed a feasible RDLN Field Project,
particularly one which can serve as a model for other communities. Please
return the form to us within one week, with your letter of recommendation
attached. Thank you for your help to RDLN.
Name
Organization
Address
Telephone Number
RURAL DEVELOPMENT LEADERSHIP NETWORK
Recommendation Form
Rural Development Leadership Network
P.O. Box 98
Prince Street Station
New York, NY 10012
(212) 777-9137/Fax (212) 477-0367
Name of Candidate
Address of Candidate
Nature of RDLN Field Project
To the Recommender:
The above person is an applicant to the Rural Development Leadership Network. We would be grateful for your assessment of this individual as a past, present and future worker in the field of rural community development. Through the program, participants implement an RDLN Field Project, take part in structured study, and convene with other partici-pants in a month-long RDLN Institute. We are looking for people of good character, strong commitment to rural community development, ability to make a long-range contribution to the development of their home community or to rural community development more generally and those who have proposed a feasible RDLN Field Project, particularly one which can serve as a model for other communities. Please return the form to us within one week, with your letter of recommendation attached. Thank you for your help to RDLN.
Name
Organization
Address
Telephone Number
RURAL DEVELOPMENT LEADERSHIP NETWORK
Recommendation Form
Rural Development Leadership Network
P.O. Box 98
Prince Street Station
New York, NY 10012
(212) 777-9137/Fax (212)477-0367
Name of Candidate
Address of Candidate
Nature of RDLN Field Project
To the Recommender The above person is an applicant to the Rural Development
Leadership Network. We would be grateful for your assessment of this individual
as a past, present and future worker in the field of rural community development.
Through the program, participants implement an RDLN Field Project, take
part in structured study, and convene with other participants in a month-long
RDLN Institute. We are looking for people of good character, strong commitment
to rural community development, ability to make a long-range contribution
to the development of their home community or to rural community development
more generally and those who have proposed a feasible RDLN Field Project,
particularly one which can serve as a model for other communities. Please
return the form to us within one week, with your letter of recommendation
attached. Thank you for your help to RDLN.
Name
Organization
Address
Telephone Number
BOARD OF DIRECTORS
Moises Loza (Chairman) - Former Executive Director, Housing Assistance Council (DC)
Shirley Sherrod (Vice Chairwoman) - Southwest Georgia Project, Southern Rural Black Women's Initiative (GA)
John Zippert - Federation of Southern Cooperatives, Greene County Democrat (AL)
Twila Martin-Kekahbah - Former Chair, Turtle Mountain Band of Chippewa (ND)
Mily Treviño-Sauceda - Alianza Nacional de Campesinas (CA)
Isao Fujimoto, PhD - University of California, Davis
-----
Starry Krueger, President
RURAL DEVELOPMENT LEADERSHIP NETWORK
P.O. Box 98, Prince Street Station, New York, NY 10012
(212) 777-9137/FAX(212) 477-0367/E-Mail: rdln@ruraldevelopment.org
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