Prefix:

Mr. Mrs. Ms. Dr.

First Name:*

Middle Name:

Last Name:*

Suffix:

Title:*

Company Name:*

Business Address:*

Address 2:

City:*

State:*

Choose a State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

ZIP:*

Business Phone:*

Business Fax:

Business Email:*

Business Website:

Home Address:

Home Address 2:

City:

State:

Choose a State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

ZIP:

Home Phone:

Cell:

Home Email:

Preferred Address?

Work Home

Referred By:

Employer Recommendation Friend Co-Worker Family Member News Article Web Search In the Press Received Materials Web Site E-mail Event Colleague Arts & Business Council Newsletter Arts & Business Council Website Arts & Business Council Orientation Arts & Culture Organization Company Event Company Website/Intranet Other

If "Other"...

Name of the person who referred you to our program?

Please select the types of arts organizations that might interest you. Select all that apply:

Art Museums
Art Galleries
Contemporary Art
Art Centers
Arts Education
Ethnic Museums
Literary Arts
Libraries/Archives
History Museums
Historic Preservation
Historic Sites
Horticultural
Zoological
Science Museums
Media Arts
Performance Art
Dance, Ballet
Dance, Folk/Ethnic
Dance, Modern
Music, Chamber
Music, Choral
Music, Jazz
Music, New
Music, Opera
Music, Symphonic
Theater, Avant-garde
Theater, Children's
Theater, Musical
Theater, Traditional

Please describe any memberships, arts events you attend, your own work in the arts, etc.:

Type:

Emerging
Established

Size:

Small
Medium
Large

Preferences:

Youth
Multicultural/Ethnic
Community Based

Please select all geographic regions in which you are available to offer support:

Center City Philadelphia
Philadelphia County
Bucks County
Chester County
Delaware County
Montgomery County
Camden County
New Castle County

Please describe the most significant experiences you have had:

Please select the areas in which you have expertise:

Architecture/Space Planning
Legal Affairs
Event Planning
Marketing/Market Research
Financial Accounting/Planning
Organizational Management
Graphic Design
Public Relations
Group/Meeting Facilitation
Real Estate Management
Human Resources Management
Strategic Planning
Information Technology
Team Building/Group Dynamics
Other: Specify

To upload a resume, click the button below. A window will appear with further instructions. Please make sure the window does not get blocked by a pop-up blocker.

Please check the boxes below to confirm you understand our application process:

I understand I must submit a letter of support from my CEO or manager.
I understand there is a Business On Board program fee of $2,500, which is due prior to the first session.
I understand I am expected to attend all four training sessions (10/9, 11/6, 12/4, and a date TBA 4/2010.)