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Nułyah Program
Thank you for your interest in CIRI's new mid-level career leadership development program. Please take a few moments to fill out and submit this form.
17
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1
Legal Name
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First Name
Last Name
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2
Mailing Address
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Street Address
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City
State / Province
Postal / Zip Code
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Afghanistan
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Algeria
American Samoa
Andorra
Angola
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Argentina
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Aruba
Australia
Austria
Azerbaijan
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Bangladesh
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Belgium
Belize
Benin
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Bolivia
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Botswana
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Brunei
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Canada
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Cuba
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Fiji
Finland
France
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Ghana
Gibraltar
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Japan
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Jordan
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Kenya
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South Korea
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Latvia
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Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
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3
Email
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example@example.com
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4
Mobile Number
*
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Please enter a valid phone number.
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5
Text Message Consent
*
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I agree to receive text messages related to program updates. Message and data rates may apply. Text messaging is optional and not required to apply.
Yes, I agree
No, I disagree
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6
Eligibility
*
This field is required.
I have reviewed and understand the Nułyah Program's
definition of a mid-level career professional
and confirm I meet those requirements.
YES
NO
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7
Are you a CIRI Shareholder or confirmed Descendant?
*
This field is required.
Click
here
to learn more information on becoming a confirmed Descendant.
Please Select
Yes, I'm a CIRI Shareholder
Yes, I'm a confirmed CIRI Descendant
Yes, I'm a CIRI Descendant, but I still need to register
No, I'm not a CIRI Shareholder, confirmed Descendant or Descendant
Please Select
Please Select
Yes, I'm a CIRI Shareholder
Yes, I'm a confirmed CIRI Descendant
Yes, I'm a CIRI Descendant, but I still need to register
No, I'm not a CIRI Shareholder, confirmed Descendant or Descendant
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8
How many years of demonstrated experience do you have in a mid-level career?
*
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Please Select
Less than 1 year
1-4 years
5-15 years
15+ years
Please Select
Please Select
Less than 1 year
1-4 years
5-15 years
15+ years
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9
Do you have an undergraduate degree or equivalent in education/experience?
*
This field is required.
YES
NO
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10
I understand the time commitment required and confirm my ability to fully participate in the program for its full duration (March to December).
*
This field is required.
Yes, I understand and can commit to the program's full duration.
No, I cannot commit to the program's full duration.
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11
Can you participate in 2-hour, monthly, in-person (if local to Anchorage area) or virtual workshops?
*
This field is required.
Workshops will be held during Alaska business hours (8 a.m. to 5 p.m.). Please note, CIRI does not provide travel for this program.
YES
NO
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12
Can you participate in 1-hour, monthly, one-on-one virtual leadership coaching?
*
This field is required.
YES
NO
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13
Can you commit to completing tasks as assigned to support the individualized leadership coaching, including leadership assessments and associated development tools?
*
This field is required.
YES
NO
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14
Are you committed to completing monthly evaluations on the program and its content for future program enhancements?
*
This field is required.
YES
NO
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15
If applicable, I have made my employer aware of the time commitments of the Nułyah Program and have their support to participate.
*
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YES
NO
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16
Resume
*
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Your most current resume must include your work history and education.
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17
Statement of Purpose
*
This field is required.
Note: Your statement of purpose is weighted heavily in the selection process and should include the following: 1) Briefly describe your mid-level career leadership experience and how it prepares you to actively participate in this program. 2) CIRI's core values are Mission-Driven, Excellence, Honor, Respect and Unity. Which three professional values guide your work most, and how have you demonstrated them? 3) What leadership skills do you feel most confident in? 4) What leadership skills would you like to develop further? 5) What do you hope to gain from this program?
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Nułyah Program - Interest Form
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