Burleson Chamber Ambassador Application

Leadership Burleson
Application
"Building a better Burleson of tomorrow by
cultivating the emerging leaders of today."

Leadership Burleson is a Burleson Area Chamber of Commerce program for individuals who work in and around the City of Burleson, Texas. Participants from diverse backgrounds gain an expanded knowledge of our community; to build relationships with other; to engage with political, civic and business leaders; and to create opportunities for a more active and effective role of leadership and volunteerism in our community.

To ensure the quality of the Leadership Burleson experience, only one class is offered per year and class size is limited.

Candidates for the program meet the following criteria:

·         Serve in a leadership capacity in organizations related to their profession, academic institutions, or other young professionals’ organizations.

·         Are committed to personal growth and career advancement while serving the Burleson community.

·         Have been active in volunteerism and want to strengthen leadership practices to enhance their potential.

·         Are considered by peers or employers as emerging leaders in business, government, non-profit, service sectors or as an entrepreneur.

·         Aspire to become actively engaged in Burleson through decision making roles on community boards, city commissions and non-profit volunteerism roles.

·         Possess high standards of personal quality and integrity.

·         In order to be eligible for a certificate of completion, Leadership Burleson will require participants to attend ALL MEETINGS and ALL OUTINGS. We understand unexpected events happen, if you must miss a session, you can make it up by volunteering at one of our chamber events.

·         Supervisor/Employer will be notified of absences and make up arrangements. They will also be invited to the Certificate of Completion Ceremony at the end of the year.

·         By submitting this application, participants agree they can and will commit the time required for the program. If employed, the participant has the full endorsement of their employer to commit the time required as a participant in the program.

The 2023 Program Fee is $750.00 and must be submitted with your completed application.

Applications are due to the Chamber by February 1, 2023.

This fee covers expenses for all
Leadership Burleson meetings and outings.
Applicant:*

First Name Last Name
Nickname:
Spouse's Name:
Home Address:

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Business Name:*
Business Address:*

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Business Phone:*

Area Code Phone Number
Cell Phone:

Area Code Phone Number
E-mail:*
Business Website / Social Media:
Membership in the Burleson Area Chamber of Commerce is required to be a participant in the Leadership Burleson Program. Are you or is your company an active Chamber Member?

YesNo
Leadership Burleson will require you to attend ALL monthly meetings in order for you to complete and receive full benefit of the programs. Do you agree to this level of participation?

YesNo
Does your Employer agree and fully endorse this level of participation?

YesNo
Signature:*

Clear
Employer Signature (to acknowledge full endorsement):*

Clear
Please provide a brief summary of your professional career, experience and/or education.
Please list any community, civic, professional, education and religious organizations in which you have been involved. If you are new to Burleson, please list activities in your previous community.
What is one issue facing Burleson that is a personal concern to you? How would you use your leadership skills to benefit the community?
Why do you want to participate in the Leadership Burleson Program?
What specific skills and/or knowledge do you hope to receive through your participation with Leadership Burleson?
Participant Signature:

Clear
Should be Empty: