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RURAL DEVELOPMENT LEADERSHIP NETWORK


APPLICATION


CANDIDATE




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) - Executive Director, Housing Assistance Council (DC)

Shirley Sherrod (Vice Chairwoman) - Federation of Southern Cooperatives
Southern Rural Black Women's Initiative (GA)

John Zippert - Federation of Southern Cooperatives, Greene County Democrat (AL)

G. David Singleton - Partner, Applied Development Economics (CA)

Twila Martin-Kekhbah - United Tribes Technical College (ND)
Former Chairperson, Turtle Mountain Band of Chippewa Indians

The Honorable Dr. Unita Blackwell - Former Mayor, Mayersville, MS
Author, Barefootin' (Crown, 2006)

Anita LaRan - Helping Hands/Mujeres Unidas (NM)

Mily Treviño - Sauceda - Organización en California de Lideres Campesinas (CA)

Maria Varela - Rural Resources Group, Colorado College (NM/CO)

-----

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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