Thinkhouse Design

Application For

Please choose the Cohort for which you are applying.
Cohort 3 (British Columbia)

Residential Seminar Dates:
Aug. 11-13, 2009, Apr. 6-8, 2010, Sept. 21-23, 2010
Application Deadline: May 30, 2009
Cohort 4 (Ontario)

Residential Seminar Dates:
Oct. 27-29, 2009, Apr. 27-29, 2010, Oct. 26-28, 2010
Application Deadline: June 30, 2009
Please note:

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Part A: Your Organization
Organization Name
Legal Name (if different from above)

If your organization is registered under a different name with the CRA, please enter it here.
Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Mailing Address (if different from above)
Phone
Extension
Fax
Website Address
CRA Charitable Number
Annual Budget

What is your organizations annual budget?
Mission Statement

What is your organizational mission statement?
Values Statements

What values has your organization established?
Vision

What vision has your organization developed for the future?
History

Give a brief historical overview of your organization (one to two paragraphs)
Primary Contact

Provide contact information for the person we will communicate with regarding this program
Name First Last
Provide contact information for the person we will communicate with regarding this program
Title
Email
Phone
Leadership Team

List the team members who will be participating in FreeForm. Team members are required to:
• Attend the three Residential Seminars
• Complete assignments, including an Organizational Development Project
• Participate in a Spiritual Retreat
• Complete FreeForm Evaluations
Name & Title
Email
Name & Title
Email
Name & Title
Email
Name & Title
Email
In order to help us form cohorts of leadership teams that will gain the maximum benefit from the FreeForm program, please complete the following:
Part B: Your Interest and Mandate
1

Based on the overview of FreeForm program outlined earlier in this Application - its goal, desired outcomes, and format - describe why and how this program will be important for your organization and its leadership team at this time.
2

As outlined on page 1, World Vision Canadian Programs focuses its efforts on empowering community-based organizations to end poverty in their circles of influence. Their partners share a faithful expression of Christian witness and a vision for peace and well-being in our communities.

Please provide a brief description of how your organization’s mission, mandate, and programming intersect with World Vision Canadian Programs’ mandate.
Have you completed a FreeForm Scholarship Application form?
Yes No
If ‘Yes’, what amount have you requested?
Name of Organization
Completed By
Title/Position
Date
Please include the following to complete your FreeForm application:

• 1-Page Cover Letter *
• Most Recent Annual Report *
• Latest Financial Statement *
• On-line FreeForm Application Form
• On-line FreeForm Scholarship Application Form (if applicable)

Email the items with an ‘*’ to: info@freeformprogram.com and submit all of the above by the deadline date shown for your selected Cohort.
Do Not Fill This Out

Thinkhouse Design

Cohort 3 (British Columbia)

Cohort 4 (Ontario)

Please note:

Part A: Your Organization

Primary Contact

Leadership Team

Part B: Your Interest and Mandate

1

2

Please include the following to complete your FreeForm application: