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New ES Membership Application
Welcome to Envision Success! As a non-profit organization, and as our new Independent Living House begins its new operations, we wish to keep official documentation of our membership. We are asking all interested parties to complete this official Envision Success Application.
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Email
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Your email
Envision Success
Last Name
Your answer
First Name
Your answer
Name any Board of Directors with whom you are familiar.
Your answer
How long have you been familiar with Envision Success?
One year or less
Two years
More than 3 years
Clear selection
This is the mission statement of Envision Success: "
E
nvision Success is committed to working with the youth of all ages and young adults in the Greater Community of Philadelphia. Our goal is to encourage independent living (IL) and positive youth development (PYD) for young adults, by referring and placing young adults in specially-designed supervised independent living (SIL) homes or programs to help them jump start the skill set needed in the real world." Which part appeals to you?
Your answer
What skills can you bring to the Envision Success membership?
Your answer
How much time, per month, can you commit to the volunteerism of Envision Success?
Your answer
In what particular area/event would you prefer NOT to work in?
Your answer
What are your strong points/areas of expertise?
Your answer
With which group do you work best?
Teens
Young adults
Wide age range of adults
Senior citizens
All of the above
Clear selection
With which group do you do your best work?
Small teams, i.e., 2 to 4 people
Medium size groups, i.e., 5 to 8 people
One-on-one
Other
Clear selection
Can you commit to one general membership meeting one time a year in Philadelphia?
Yes
No, not this year
Maybe
Clear selection
What is your professional title?
Your answer
How many years in your field?
Your answer
How can you help Envision Success?
Your answer
How can Envision Success help you?
Your answer
At this point in the questionnaire, please leave your contact information, i.e., (1) Home/Work Address, (2) Cell Phone Number, and (3) Email Address, and (4)Birthdate — month and date only.
Your answer
Thank you for your time and consideration. With your submission, the ES Executive Board will quickly review your application and forward to you an official membership certification.
Your answer
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