DignityUSA Leadership Academy Application

Leading With Purpose




Please complete and submit this form and a narrative of maximum 2-page length.

Return to Daniel Barutta at dbarutta@gmail.com.


Application deadline:               Monday, February 28, 2022. 

Notification:                                Selectees will be notified in April.


Name:               ___________________________________________

Pronouns:        ___________________________________________


Email:                ___________________________________________

Phone/Cell:     ___________________________________________


Who could tell us more about your leadership aspirations or experiences? (Name/email or cell)

Person 1:          ____________________________________________

Person 2:               _____________________________________________


Please submit a narrative describing yourself and your motivations to be a participant in the Leadership Academy. We encourage you to address the following topics.  


Describe your current participation in Dignity either at the local chapter/community level, the national level, and as a national member.


What motivates you to become a leader? Since many people are leaders and may not realize it yet, can you think of any examples in your life where, in fact you have led or do lead people?


What kind of leadership skills would you like to gain or improve?


Consider topics such as your goals in life, your spirituality, what really motivates you, interesting aspects of your life such as hobbies, community involvement, and more. 


Describe an experience with someone whose life experience is different than your own.


Please feel free to provide anything you would like us to know about you.


Thank you!  Questions contact Daniel Barutta: 202-607-8722; dbarutta@gmail.com.