WIELD Application
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Full Name *
Email  *
Mailing Address *
Phone *
Date of Birth *
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For which cohort are you applying? *
How did you hear about WIELD? *
Why are you interested in becoming a WIELD Fellow? *
Briefly describe your upbringing: *
What are the 3 biggest changes you want to make in your life over the next 6 months? *
What are 3 things you would like to accomplish in your life over the next 2 years? *
What are your business/career goals?  *
List 5 adjectives that describe you at your best: *
List 5 adjectives that describe you at your worst: *
What are 3 major concerns you have about life? *
What motivates you? *
Who are the key people in your life, and what do they provide for you? *
Is your life one of your choosing? If no, which parts are being chosen for you? *
Looking at the last 6 months of your life, do you like the direction your heading? Please explain your response. *
What is the hardest thing you've had to overcome in life? *
What would you like to contribute to the world? *
How would WIELD benefit from your participation? In other words, why should you be selected as a Fellow? *
Please provide the name and email addresses of 2 references who can attest to your character: *
Anything else you would like us to know about you? *
Best time to contact you for an interview:
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