ELP Application Save my progress and resume later | Resume a previously saved form Resume Later In order to be able to resume this form later, please enter your email and choose a password. Your Email: A Password: Confirm Password: Final submissions must be inputted via this form. For your convenience there is a document with the questions listed in an editable format for you to reference and compile your answers here. It is assumed that you have already read the brochure found HERE. About the Applicant... First Name Last Name Title Email Phone Number GenderPlease select... Female Male Non-binary Non-conforming Two-Spirit I Prefer Not to Share Other Which do you self-identify as? (select all that apply) A person with a Disability (As defined under the Employment Equity Act)AfricanAfrican Nova Scotian (As defined by African Nova Scotian Affairs)AsianBlackCanadianCaribbean CanadianFirst NationFrancophoneI prefer not to shareIndigenous from outside Turtle Island/North AmericaInuk (Inuit)LatinxLGBTQIA2SMétis (i.e. members of the Métis Nation, namely, the Métis Nation of Ontario, the Manitoba Métis Federation, the Métis Nation—Saskatchewan, the Métis Nation of Alberta and the Métis Nation British Columbia)Middle EasternMulti-racialOther White If choosing Other, please feel free to elaborate Personal Linkedin Profile link Personal Facebook Link Street Address City ProvincePlease select... ALBERTA BRITISH COLUMBIA MANITOBA NEW BRUNSWICK NEWFOUNDLAND AND LABRADOR NORTHWEST TERRITORIES NOVA SCOTIA NUNAVUT ONTARIO PRINCE EDWARD ISLAND QUEBEC SASKATCHEWAN YUKON TERRITORIES Country Postal Code Nominated By (optional) About the company ... Organization Name Number of Employees (Full Time Equivelant) Percentage of Ownership in the Company (Explain if under 50%) Company Age / Years as CEO Annual Revenue (of all companies) Company URL Application Questions The questions below allow the judges to determine the fit between you and ELP. You are not able to exceed the allotted space for any given answer. Applications must be received by March 31st. Describe your business (activity/size/geography) What are your proudest business accomplishments to date? What is your vision for how your company will grow in the next 10 years? Describe your motivation to apply to become a member of ELP. What are the top decisions that you face during the next year? References Provide the names as well as the emails and/or phone numbers for 2 business references and an ELP alumnus you have discussed this with (if possible). By sending this application, you confirm that you have had a discussion with an alumni or WMI staff about the program cost & ongoing program expectations. 1. Reference or Alumnus Name, Email and/or Phone 2. Reference or Alumnus Name, Email and/or Phone 3. Reference or Alumnus Name, Email and/or Phone UNB and the WMI are committed to protecting the personal information of all applicants. The information collected on this application form will be used solely for the purposes of selection for this years’ ELP and will be accessible only to the judges (marked confidential) and WMI staff. For more information on the protection of personal information at UNB contact the Wallace McCain Institute (c/o UNB President's Office), Sir Douglas Howard Hall Rm 111 University of New Brunswick 3 Bailey Dr. PO Box 4400 Fredericton NB Canada E3B 5A3 www.unb.ca/secretariat (506) 453-4613. Applications will only be retained in the WMI electronic files indefinitely but destroyed by judges after the selection. reCAPTCHA helps prevent automated form spam. The submit button will be disabled until you complete the CAPTCHA. Save my progress and resume later | Resume a previously saved form
